By reviewing the pilot experiences of drugs payment standard under basic medical insurance in Sanming(Fujian),Chongqing and Fujian,it pointed out that the drug payment standard system should be designed following the principle of classification management.It was necessary to rationally divide payment standard group,select the appropriate method for payment standard,establish dynamic adjustment mechanism and solve problems of the belonging and burden of price difference so as to ensure the effective implementation of medical insurance cost control policy.

AIM: To study the technological parameters of the purification process of total salvianolic acid(TSA) of Radix Salvia Miltiorrhizae(RSM) with D101 macroreticular resin. METHODS: Based on orthogonal experiment,the reservation rate of TSA in macroreticular resin columniation was took as index to investigate the chief influential factors in the purification of TSA. RESULTS: The volume of distilled water and the content of TSA in RSU solution had significant effect on the reservation rate of TSA in macroreticular resin columniation. With the help of macroreticular resin,the reservation rate of TSA could reach 87.52%.Its purity was 77.74%,comparing with crude extract,increased by 3.6 times. CONCLUSION: The method of purifing TSA of RSM with D101 macroreticular resin is feasible,it could be applied to industrialized production of TSA of RSM.

OBJECTIVE:To establish an RP-HPLC method for determination of plasma concentration of glimepiride (GM) in Beagle dogs. METHODS: Plasma sample was separated on Agilent Eclipse XDB-C8 column with column temperature kept at 30 ℃,and the mobile phase consisted of acetonitrile-methanol-10 mmol?L-1 potassium dihydrogen phosphate (65∶40∶95,pH value adjusted to 7.2) at a flow rate of 1.0 mL?min-1. The UV detection wavelength was set at 227 nm. Plasma sample were pretreated by liquid-liquid extaction with gemfibrozil as an internal standard. Plasma concentrations of GM in 6 Beagle dogs at different time points were determined after a single sublingual dosing of 2 mg GM spray. RESULTS: The linear range of GM was 50～2 500 ng?mL-1 with a lowest detection limit of 20 ng?mL-1. The intra-day RSD and inter-day RSD were all less than 15%. The extraction recovery rate was 71.27%～103.5%,and the methodological recovery rate was 87.97%～ 98.95%. CONCLUSION: This method is simple in sample treatment and sensitive,and it is applicable for analysis of GM in biological sample.

Objective To investigate the clinical effect of continuous blood purification therapy in patients with severe heart failure and renal failure.Methods The clinical data of 38 patients with severe heart failure and renal failure treated by continuous blood purification were analyzed retrospectively.Heart rate,mean blood pressure, APACHE II score,Boston score,blood biochemistry,blood gas analysis and cardiac function changes were compared before and after the treatment of continuous blood purification.Results After treatment 12h and 72h,patients breath-ing[(19.24 ±2.88)times/min],heart rate[(88.57 ±15.68)times/min],APACHE Ⅱ [(14.28 ±3.26)points] and the score of Boston[(6.27 ±1.25 )points]were significantly decreased compared with those before treatment [(35.68 ±5.97)time /min,(131.24 ±24.26)time /min,(26.34 ±5.96)points,(17.88 ±2.87)points],and the differences were statistically significant (t =3.13 3.45,2.12,4.11,3.67,5.68,3.44,609,all P <0.05).38 cases of severe heart failure with renal failure after continuous blood purification treatment,markedly effective in 16 cases, effective in 12 cases,ineffective in 10 cases,the total effective rate was 73.68%.Patients after continuous blood purification treatment,the SCr[(168.15 ±31.16)μmol/L],BUN [(13.13 ±3.44)mmol/L]were significantly decreased.pH[(7.41 ±0.13)],HCO3 [(25.57 ±5.11)mmol/L],PaO2 [(88.26 ±7.72)mmHg],SaO2 [(96.43 ± 3.14)%]and blood biochemistry and blood gas index decreased markedly,and the differences were statistically significant (t =4.55,3.21,2.11,3.45,673,4.21,all P <0.05).After the examination of echocardiography,stroke volume (SV)[(59.31 ±6.58)mL],cardiac output (CO)[(4.57 ±0.62)L/min]and left ventricular ejection fraction (LVEF)[(68.12 ±4.88)%]increased significantly compared with before treatment,and the differences were statistically significant (t =4.33,5.12,367,all P <0.05).Conclusion Continuous blood purification could effectively maintain the hemodynamic stability of patients,and is safe and effective in the treatment of severe heart failure with renal failure.

Objective To investigate the emotional distress and coping style during acute stage in patients following acute traumatic injury, and the relationship in different coping patterns and emotional distress. Methods A total of 118 patients with acute traumatic injury were included in our investigation.Emotional distress was assessed with the Hospital Anxiety and Depression scale. Coping style was measured with the Medical Modes Questionnaire. Descriptive analysis, independent samples t test and multiple linear regression analysis were used. Results Emotional distress occurred in 50.00% of the patients with acute traumatic injury,22.40% patients only presented anxiety, 17.30% patients only presented depression, and 10.20% patients presented both anxiety and depression. Yielding and avoidance coping styles were more frequently used in patients with depression. Conclusions Incidence of emotional distress was highly fre-quently, many factors were associated with patients" affection reaction.

Objective To explore the efficacy of radiofrequency ablation (RFA) and ethanol ablation(EA) for treating partially cystic thyroid nodules.Methods One hundred and twenty-four patients with a single partially cystic thyroid nodules which caused pressure symptoms or cosmetic problems were treated with RFA (n =42),EA (n =39) or RFA + EA(n =43).The inactivation rate of the nodule,tumor volume reduction rate,symptom scores (0-10) and complications were evaluated before and after treatment.Results The mean inactivation rate of RFA,EA and RFA + EA groups was (87.50 ± 5.77) ％,(57.00 ± 6.12) ％,(90.03 ± 5.39) ％,respectively.The inactivation rate of the nodule was negatively related to the volume of the solid part of the nodule.As to nodules with the volume ranging from 30 to 45 ml,the inactivation rate of RFA group was lower than RFA + EA group.Nodule volume reduction ratio (percentage) at 12-month follow-up was 90.45％ for RFA group,69.88％ for EA group,and 93.28％ for RFA + EA group.Regarding mean volume reduction,there were no difference between RFA + EA and RFA group (P ＞0.05),while there were significant differences between RFA + EA and EA group (P ＜0.05),also RFA and EA group (P ＜0.05).The patients in EA subgroup with cystic part percentage less than 50％ had a unsatisfying outcome (the volume reduction ratio less than 50％),while there were no differences(P ＞0.05) on the volume reduction ratio of nodule based on cystic part percentage between RFA group and RFA + EA group.The rate of the complication was 7.14％,2.56％,2.33％,respectively.Conclusions Ultrasound-guided percutaneous aspiration combined with RF ablation yielded better results than EA ablation.But due to ethanol ablation being less expensive and simpler to perform than RFA,ethanol ablation should be the first line treatment technique for benign thyroid nodules with cystic part percentage more than 50％,while radiofrequency ablation as first-line treatment for benign thyroid nodules with cystic part percentage less than 50％.

An integration of medical data management system based on WEB and data mining tool is reportedly in this paper. In the application process of this system, web-based medical data mining user sends requests to the server by using client browser with http protocol, the commands are then received by the server and the server calls the data mining tools remote object for data processing, and the results are sent back to the customer browser through the http protocol and presented to the user. In order to prove the feasibility of the proposed solution, the test is done under the NET platform by using SAS and SPSS, and the detail steps are given. By the practical test, it was proved that the web-based data mining tool integration solutions proposed in this paper would have its broad prospects for development, which would open up a new route to the development of medical data mining.
Data Mining ; Internet ; Medical Informatics ; Software

Objective:To investigate the change of thymus in different period of EAE mice. Methods: The thymic index and thymocyte number at 0,10,15,20 days after EAE induced were recorded. The percent of thymic apoptosis and CD4+CD44+T cells in spleen was acquired by Flow Cytometry. The content of p53 and Bcl-2 gene was detected by PCR and electrophoretic technique. Results:The thymic index and thymocyte number correspondingly reduced at 0,10,15 days after EAE induced. Apoptotic rate of thymocyte increased at 10,15 days after EAE induced,highest at 10 days. The percent of CD4+CD44+T cells also increased at 10,15 days after EAE induced, highest at 10 days. The content of p53 increased, while Bcl-2 reduced at 10 days after EAE induced. Conclusion:The atrophy of thymus is most serious at 15 days after induction;while the apoptotic percent is highest at 10 days after induction,which have a relationship with regulation of p53 and Bcl-2. The change of thymus in EAE mice closely related with EAE attack,and the recovery of thymus precede EAE.

AIM: To explore the regulatory mechanism of n erve growth factor (NGF) on neurokinin A in the experimental asthmatic guinea pi g. METHODS: Radioimmunoassay was used to determine the alteration of neurokinin A levels in the lower respiratory tract and visceral sensory afferent sites while NGF was absent (inhalation of NGF antibody through nasal cavity) in the asthmatic guinea pig. RESULTS: The contents of neurokinin A in the trachea, bronchus, lung, C 7-T 5 spinal ganglia and the correspondent spinal dorsal horn, nodose ganglia and solitary nucleus area in the experimental asthmatic guinea pig with the absent of NGF in the respiratory tract were much lower than those in the as thmatic and control groups (P

Objective To evaluate the efficacy and safety of tacrolimus (TAC) for treatment of Henoch-SchSnlein purpura nephritis in children.Methods Forty children with Henoch-SchSnlein purpura nephritis (pathological grade Ⅲ-Ⅵ) in Children's Hospital Affiliated to Soochow University from January 2013 to June 2016 were selected and divided into TAC group (n =19) and cyclophosphamide (CTX) group (n =21).The children in TAC group were given TAC orally;the children in CTX group were given CTX pulse therapy intravenously.The 24 h urine protein,urine red blood cell count,serum albumin,serum creatinine and blood urea nitrogen of children before treatment and after 6 months treatment were observed and compared between the two groups.The treatment effects and adverse reactions of patients were observed and compared between the two groups.Results There was no statistic difference in the 24 h urine protein,urine red blood cells count,serum albumin,blood creatinine and blood urea nitrogen levels of children between the two groups before treatment (P ＞ 0.05).The 24 h urinary protein and urine red blood cells count of children after 6 months of treatment in the two groups were significantly lower than those before treatment (P ＜ 0.05);there was no statistic difference in the serum albumin,serum creatinine and blood urea nitrogen levels of children in the two groups before treatment and after 6 months of treatment (P ＞ 0.05).Mter 6 months of treatment,the 24 h urine protein and urine red blood cells count of children in TAC group were significantly lower than those in the CTX group (P ＜ 0.05);there was no statistic difference in the serum albumin,serum creatinine and blood urea nitrogen levels of children between the two groups (P ＞ 0.05).After 6 months treatment,the effective rate of children in the TAC group was significantly higher than that in the CTX group (x2 =4.607,P ＜ 0.05).The incidence of adverse reactions of children in the TAC group was significantly lower than that in the CTX group (x2 =4.043,P ＜ 0.05).Conclusion TAC is effective in treatment of Henoch-Sch(o)nlein purpura nephritis in children.It is easy to take,and has less adverse reactions.