The practice of catastrophic disease insurance in China is an important attempt to decentralize administration and build a service-oriented government.Under the developing model of governmental service purchase, an efficient supervision is the key part of ensuring and upgrading the effectiveness of catastrophic disease insurance system.Starting from theoretical analysis on the service outsourcing of the operating mechanism and its features, this paper discusses the legal attributes and supervision responsibilities of catastrophic disease insurance in China, and then explores the main problems of the current regulation system in view of regulatory responsibilities, supervisory subjects, as well as supervision contents, methods and means, etc.For these problems, it's urgent to re-draw a definite boundary of government responsibilities for the system, determine the supervisory subject as human resources and social security departments, and develop unified standards at provincial level for the bidding process.It's also necessary to establish a scientific performance evaluation system, promote multi-sector joint supervision among different government sectors involved, practice information sharing and means of digital regulation, in order to achieve efficient supervision of catastrophic disease insurance in China.

The rapid development of MOOC is both an opportunity and a challenge for the higher education in our country .The information literacy of college and university teachers plays an important role in the success implemen-tation of MOOC.The development and characteristics of MOOC were described, the problems existed in information literacy of college and university teachers under MOOC environment were analyzed with strategies put forward for improving the information literacy of college and university teachers from the aspects of ideological concept , training methods, assessment criteria, and information environment .

Aim To study the effects of pyrrolidine dithiocarbamate(PDTC) on matrix metalloproteinase-9(MMP-9) expression in alveolar macrophages(AM) induced by TNF-?,and then to explore it's signal pathway.Methods AM were collected from bronchoalveolar lavage fluid in patients with chronic obstructive pulmonary disease.AM were pretreated with PDTC and then stimulated by TNF-? or IL-1.MMP-9 mRNA expression was detected by semi-quantitative reverse transcription-polymerase chain reaction and MMP-9 protein expression was detected by Western blot.Phospho-I?B? protein levels induced by TNF-? or IL-1 were detected by Western blot.NF-?B activity was detected by electrophoretic mobility shift assay.Results Both the mRNA and protein levels of MMP-9 induced by TNF-? in AM were significantly elevated in a dose dependent manner(P0.05).PDTC had distinct effect of inhibiting the activation of NF-?B induced by TNF-? or IL-1 in a dose-dependent manner(P0.05).Conclusions NF-?B plays an important role in MMP-9 expression induced by TNF-? in AM;PDTC can down-regulate MMP-9 expression induced by TNF? in AM possibly through preventing the degradation of I?B? via ubiquitylation-proteasome proteolytic pathway.

The key policy for the Chinese governments to support the health insurance development has been to provide high percentage of premium subsidies in the 1 . 1 billion Yuan insured for the two of the basic medical insur-ance systems. According to the current policy, governments should share the responsibility of several hundreds of bil-lions Yuan of subsidies per year. However, because of the indistinct of the responsibility between governments at all levels and the shortage of systematic and long-term duty share mechanism, the current system has been directly affect-ing the fairer and more sustainable health insurance system development. Concerning these issues, this paper primari-ly thought about the contributory principle of subsides after analyzing the present situation and the main problems. Therefore, taking the three factors including disposable income per capita, consumption expenditure per capita and fi-nancial revenue per capita into account, it provides a“5 steps approach” about the contribution of the central govern-ment fiscal subsides using entropy evaluation method, and suggests a proposed program on the governments contribu-tion liability at the provincial or decentralized level based on the “fiscal subsides index”. Thoughts and conclusions drawn from this paper have a significant meaning into the establishment of a fairer and more sustainable financial sup-port mechanism for the basic medical insurance.

AIM: To study the effects of NF-?B decoy oligonucleotides(ODNs) modified with locked nucleic acids(LNA) on gelatinases(MMP-9 and MMP-2) expression and NF-?B activity induced by TNF-? in alveolar macrophages(AM) from patients with chronic obstructive pulmonary disease(COPD).METHODS: AM was collected from bronchoalveolar lavage fluid from patients with COPD.NF-?B decoy ODNs and mismatch ODNs were modified with LNA, and transfected into AM by using Lipofectamine 2000.Then the AM were stimulated for 24 h with TNF-?.Semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR) was used to detect the mRNA expression levels of MMP-9 and MMP-2.MMP-9 protein expression was detected by Western blotting.NF-?B activity was detected by electrophoretic mobility shift assay(EMSA).RESULTS: NF-?B decoy ODNs significantly inhibited MMP-9 and MMP-2 expression induced by TNF-? in AM(P

Objective To explore the features of the airway inflammation in a rat model of chronic bronchitis and study the role of IL-8 in the pathogenesis of chronic bronchitis. Methods The rat model of chronic bronchitis was set up by injecting LPS into trachea. Cell count and cytological classification in BALF were performed in experimental group and control group. The level of IL-8 in both serum and lung tissues of the two groups rats was measured by ELISA. Results The levels of IL-8 in both serum and lung tissues in the rats with chronic bronchitis were significantly higher than those in healthy control rats.The number of neutrophil in BALF of the rats with chronic bronchitis was significantly more than that in healthy control rats. Conclusion Both IL-8 and neutrophil were involved in airway inflammation of chronic bronchitis, and might play an important role in the pathogenesis of chronic bronchitis.

Two systems which covered nearly 1. 1 billion people in China’s social health insurance, namely the New Rural Cooperative Medical Scheme ( NRCMS ) and the Urban Residents’ Health Insurance System ( URHIS ) , have been depended mainly on government support with high percentage of premium subsidies. This paper deals with the current situation and probes into the main subsidy policy problems by making an overall analysis on the policies of 31 cross-country provinces , and in result points out four problems including the long-term mechanism shortage, in-distinct responsibility between governments at different levels, the equity deficiency and the subsidies inefficiency. Finally, the paper concludes with enlightening some corresponding policies and suggestions.

Objective To investigate clinical effect of Danhong injection combined with edaravone in patients with idiopathic pulmonary fibrosis (IPF) and influence on TNF-αand TGF-β1 in serum.Methods 67 patients were randomly divided into Treatment Group (n=35) and Control Group (n=32) in Xuanwu hospital of Nanjing from March 2011 to December 2014.All the patients were treated by comprehensive conventional treatment, and then control group was treated by edaravone, treatment group were treated by Danhong injection on the basis of control group.The clinical efficiency, PaO2 , carbon monoxide diffusing capacity (Dlco) and the levels of inflammatory factors between two groups were compared.Results After treatment, the clinical total effective rate(97.14%) of treatment group was statistically higher than that of control group (75.00%, Z=-2.035,P=0.042).After treatment, partial pressure of oxygen(PaO2) and Dlco in treatment group were increased significantly(all P<0.05);and it was statistically higher then control group (all P<0.05).TNF-αand TGF-β1 in treatment group were decreased significantly (all P<0.05);and it was also statistically higher then control group (all P<0.05).Conclusion Danhong injection combined with edaravone is effective in treatment of IPF, which can significantly improve the pulmonary function and levels of inflammatory factors.

Objective To investigate the expression of tumor stem cell marker aldehyde dehydrogenase -1 (ALDH-1)in primary tumor and lymph node metastases of lymph node-positive invasive micropapillary carcinoma ( IMPC) of breast and its clinical significance .Methods The expression , location and distribution of ALDH-1 were examined by immunohistochemical staining in 103 cases with lymph node metastasis of IMPC and 110 cases with lymph node metastasis of invasive ductal carcinoma not otherwise specified ( IDC-NOS) without preoperative chemotherapy and radiotherapy , and their relationship with clinicopathological characteristics and prognostic sig-nificance was analyzed .Results ( 1 ) The positive expression rate of ALDH-1 was significantly higher in IMPC group of primary tumor and lymph node metastases (37.9% in primary tumor, 39/103 cases;47.6% in lymph node metastases, 49/103 cases)than in IDC-NOS group(21.8% in primary tumor, 24/110 cases; 23.6% in lymph node metastases, 26/110 cases)(P<0.05).(2)Expression of ALDH-1 had a significantly positive corre-lation with tumor size , histological grade , lymph node metastasis , ER-negative status , PR-negative status , and HER2 overexpression in primary tumor and lymph node metastases of IMPC (P<0.05).(3)The disease-free sur-vival of IMPC group patients was significantly shorter than that of IDC-NOS group patients(P=0.003).In IPMC patients with lymphode metastases , the disease-free survival of patients with ALDH-1 positive in primary tumor and lymph node was significantly lower than patients with ALDH-1 negative expression (P<0.05).In multivari-ate analysis, positive expression of ALDH-1 in metastatic lesions was associated with worse prognosis ( P =0.005).Conclusion ALDH-1 can be used as an independent factor for predicting prognosis of patients with lymph node-positive breast IMPC and the existence of stem cells in IMPC tumor cells may represent high IMPC lymphatic invasion , lymph node metastasis and high resistance .

Objective To investigate the effect of ulinastatin (UTI) on the expression of brainderived neurotrophic factor ( BDNF ) and remyelination in mice with experimental autoimmune encephalomyelitis ( EAE).Methods Twenty-four C57BL/6 mice were randomly divided into UTI group (U),normal saline treated group (S) and normal control group (N,n = 8,respectively).Demyelinations in the spinal cord were observed by solochrome cyanin staining.The expression of BDNF,myelin basic protein (MBP),and 2',3 '-cyclic nucleotide 3'-phosphodiesterase (CNP) in brain tissue of each group were evaluated by Western blot.Results Average clinical scores in group U at the 12,13,14,22,23,31,33,34 and 35 days were 0,0.25,0.38,0.63,0.63,0.40,0.40,0.40 and 0.40 respectively.They were significantly lower than group S at the same time ( U= 16.00,15.00,14.50,7.50,0.00,14.50,14.50,12.00 and 14.50,all P ＜0.05).Solochrome cyanin staining showed that demyelination of spinal cord in group U was also significantly improved than group S.Expressions of BDNF ( 1.96 ± 0.29),MBP (2.67 ± 0.48 ) and CNP ( 1.75 ± 0.20) in group U were all significantly higher than group S ( There were 0.80 ± 0.15,1.36 ± 0.38 and 1.06 ± 0.18 respectively,all P ＜ 0.05).Conclusions UTI has protective effect on EAE.The possible mechanism is that it could promote remyelination,and protect oligodendrocytes and neurons in EAE model by increasing BDNF expression in brain.