Given the significant improvement in terms of its coverage and compensation depth,China's basic medical insurance system has inherent setbacks in its structure as held by the authors.They hold that the medical insurance as the most important source of compensation for medical institutions,should further reform its structure of financing and reasonably raise the percentage of compensation; adjust the time reference and space reference for prepayment estimation such as the total prepaid amount; deepen supportive reforms for the payment manner.All these measures aim at minimizing impact of the payment control mechanism on routine medical activities and exploring diversified payment manners that are feasible.

Objective To study the resuscitation effect of cavum ossis infusion of hypertonic saline solution on hemorrhagic shock canine,and investigate the corresponding internal microenvironment changes.Methods Eighteen healthy Wiggers dogs weighed 16-19kg were adopted in present study and assigned into three groups(6 each): group HSH,group NS and group Sham.Hemorrhagic shock canine model was established.Dogs in HSH group received a rapid cavum ossis infusion with 7.5% hypertonic resuscitation solution(sodium chloride + 6% hydroxyethyl starch),and the dogs in group NS was only given 7.5% sodium chloride solution,while the dogs in Sham group were treated by general anaesthesia,assisted respiration with breathing machine and without bleeding and transfusion.Changes of central venous pressure(CVP),mean arterial pressure(MAP),intramedullary pressure(IMP),and the levels of blood lactate and sodium were monitored during the resuscitation phase.Results During hemorrhagic shock stage,the haemodynamic parameters MAP,CVP and IMP in groups HSH and NS decreased significantly,while blood lactate significantly increased at each time point as compared with that in group Sham(P0.05).The lactate level during resuscitation phase in group HSH decreased significantly as compared with that during hemorrhagic shock stage(P

Objective To explore the impacts of different nutrition support methods on short-term outcome in critically ill adult patients. Methods We retrospectively reviewed the clinical data of 1503 critically ill adult patients who needed nutrition support in an mixed intensive care unit (ICU) of a tertiary care university hospital from January 1994 to December 2009. The complication of nutrition support, length of stay (LOS) in ICU, morbidity of infection and multiple organ dysfunction syndrome (MODS), and mortality among different nutrition support methods were compared. Results The Nutritional Risk Screening (NRS) scores of the enrolled patients were no less than 3. LOS in early enteral nutrition (EN) patients were significantly shorter than those in not-early EN patients (P ＜ 0. 001) and parenteral nutrition (PN) patients (both P ＜ 0. 001). Infection rate (P ＜ 0. 001),morbidity of MODS (P ＜ 0. 001) and mortality (P ＜ 0. 001) were significantly lower than those in not-early EN and PN patients. LOS of patients receiving PN rich in glutamine (Gln) was significantly shorter than that in conventional formula (P = 0. 0000). Morbidity of infection (P= 0. 0252) and MODS (P = 0. 0030), mortality (P =0. 0305) were significantly lower than that of conventional patients. LOS of patients receiving intensive insulin therapy (IIT) was significantly shorter than that of controlled group (P = 0. 0000). Morbidity of infection (P =0. 0001) and MODS (P = 0. 0237) and mortality (P =0. 0427) were significandy lower than those of controlled group. Conclusions Nutritional risk is prevalent among critically ill adult patients. Early EN, PN of rich in Gln,and receiving IIT can shorten LOS, decrease morbidity of infection and MODS, and improve prognosis among these patients.

Objective To explore the effects of alanyl-glutamine (Ala-Gln) dipeptide supplemented parenteral nutrition (PN) on the short-term outcomes in critically ill adult patients.Methods In this retrospective study,we reviewed the clinical data of critically ill adult patients who were treated by standard PN from January 2006 to December 2011.The length of stay in intensive care unit (ICU-LOS),incidences of infections and multiple organ dysfunction syndrome (MODS),and mortality were compared between the group of Ala-Gln dipeptide supplemented PN (intervention group) and the group of PN without Ala-Gln dipeptide (control group).Results Finially,617 cases were enrolled in the study,including 312 cases in the control group and 305 cases in the intervention group.The ICU-LOS was significantly shorter in the intervention group than that in the control group [(17.2 ± 6.5) d vs.(16.1 ± 5.3) d,P =0.011).Compared with the control group,the incidences of infection (42.9％ vs.33.1％,P =0.011) and MODS (46.5％ vs.38.0％,P =0.030) and the mortality (34.9％vs.25.9％,P =0.014) in the intervention group patients were significantly lower.Conclusion Ala-Gln dipeptide supplemented PN can improve the short-term outcomes of critically ill adult patients.

Objective To prepare lipid-coated ultrasound microbubbles containing 10-HCPT(HLM) and explore the antitumor effects on mice xenografed H22 solid tumor using the technique of ultrasound-mediated HLM destruction. Methods Sixty-four tumor-bearing mice were radomly divided into A and B groups. Each group was divided into four groups again and administered respectively by tail vein with HI.M, non-drug-loaded microbubbles,10-HCPT and saline once a day. Ultrasound irradiation was applied on the tumor sites immediately after injection. After 7 days of consecutive treatment, all mice in group A were sacrificed and the tumors were harvested to measure weights. The tumor inhibition rate was calculated by weights. The tumor microvessel density (MVD) was detected by immunohistochemical staining. The tumor growth curve was depicted according to volumes. The survival time of mice in group B was recorded. Results The tumor inhibition rate was the highest in HLM group while this group's MVD was the lowest. Survival time in HLM group and 10-HCPT group were obviously longer compared with the control group,while no statistic difference was observed between the two groups. There was no statistic difference between the group of non-drug-loaded microbubbles and the control group. Conclusions Ultrasound irradiation mediates HLM destruction so that the drug is released from the vihicles at the same time, which can significantly enhance the tumor inhibition effect of 10-HCPT on the H22 tumor. This technique is expected to be adopted as a novel tool for liver cancer chemotherapy.

Objective To develop perfluorocarbon lipid particles and investigate their basic properties,and target them to human hepatocellular carcinoma cells in vitro by hepatoma monocolonal antibody HAb18 with avidin-biotin interaction.Methods Rotary evaporation and high pressure homogen were used to prepare perfluorocarbon lipid particles, and the appearance and distribution of them were investigated by microscope and electron microscope, the concentration and the size and electric potential were detected.The biotinylated monoclonal antibody HAbl8 was prepared, then the biotinylated degree of the antibody was determined.The biotinylated perfluoroearbon lipid particles labelled with NBD were prepared and targeted to human hepatocellular carcinoma cells in vitro with avidin-biotin interaction.Results These perfluorocarbon lipid nanoparticles were uniform and stable,and the mean diameter of them was 171.9 nm.Hepatocellular carcinoma cells were surrounded by the biotinylated particles labelled with NBD.Conclusions A steady perfluoroearbon lipid particles were prepared and the biotinylated particles can be targeted to hepatocellular carcinoma cells with avidin-biotin interaction.

We established a rapid detection method of New Delhi Metallo-beta-Lactamase Gene (NDM-1) based on Loop-mediated Isothermal Amplification (LAMP). With the application of LAMP, we designed four sets of LAMP premiers, using NDM-1 gene as the target sequence, and selected the set of optimal primers. Meanwhile, we established optimal reaction systems and conditions to carry out the sensitivity and specificity experiments. The experiment results showed that the whole detection process took only one hour and could be observed visually. In the experiment of sensitivity, NDM-1 gene had a detection limit of 6 copies in each reaction. In the experiment of specificity, we detected NDM-1 gene in 4 pathogen strains (Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae), and the total DNA from intestinal microbes and the total DNA from soil microbes. We had not detected the amplification reactions. The detection method established could rapidly detect NDM-1 gene and visualize the experiment result. The method is easy to operate and has high sensitivity and specificity and thus has great application value in basic research laboratories, emergent detection and spot detection.
Bacteria ; enzymology ; genetics ; Bacteriological Techniques ; methods ; DNA, Bacterial ; genetics ; Escherichia coli ; enzymology ; genetics ; Klebsiella pneumoniae ; enzymology ; genetics ; Nucleic Acid Amplification Techniques ; methods ; Sensitivity and Specificity ; Staphylococcus aureus ; enzymology ; genetics ; Streptococcus pneumoniae ; enzymology ; genetics ; beta-Lactamases ; genetics

Objective:To study the feasibility of transplantation of normal rat penile corpus cavernosum and major pelvic ganglion (MPG)into the renal subserous region of a Nu /Nu mouse based on allograft technology.Methods:Penile corpus cavernosum and MPG,harvested from Sprague-Dawley (SD)rats under sterile condition,were transplanted underneath the kidney capsule of Nu /Nu mice through the mi-crosurgery instruments and surgery microscope.The histopathologic changes and cellular proliferation in the transplanted penile corpus cavernosum and MPG were then analyzed at the end of 1week and 4 weeks after transplantation.Histological staining and immunohistochemical staining were used to evaluate the main outcome measures.Results:After 1 week,the tissue morphology of the transplanted corpus caverno-sum underneath the kidney capsule of Nu /Nu mice was consistent with normal penile corpus cavernosum, and blood could be observed in the penis cavernous sinus of the graft;after 4 weeks,the mophorlogy of the tranplanted corpus cavernosum near the kidney was consistent with normal penile corpus cavernosum, while fibrosis was noteworthy in the graft away from the kidney,but blood could still be seen in the penis cavernous sinus.After 1 week,the tissue morphology of the transplanted MPG was consistent with normal MPG,multiple islet-like cell clusters could be seen in the transplanted MPG in the renal subserous re-gion,and angiogenesis could be observed near the kidney;after 4 weeks,a network of blood vessels was clearly visible away from the kidney,and islet-like cell clusters were still clearly observed in the trans-planted MPG.In addition,ki67 positive cells were observed in the transplanted penile corpus cavernosum and MPG after 4 weeks of transplantation,which indicated that there was still cell proliferation activity in the grafts.Conclusion:The transplanted corpus cavernosum and MPG underneath the kidney capsule of Nu /Nu mice could survive at least 4 weeks.Moreover,the inner structure of the transplanted corpus ca-vernosum and MPG was close to the normal tissue.The underlining mechanism may be related to the lo-cal microenvironment underneath the kidney capsule of Nu /Nu mice and the neovascularization in the transplanted grafts.

From the perspective of the government′s positioning of public hospitals, the basic problems of functional positioning of public hospitals are clarified. According to different positioning subjects, the positioning of public hospitals is divided into three categories: government positioning, social positioning and self-positioning. By analyzing the connotation of the positioning mechanism of public hospitals, the outstanding performance of the insufficient realization of the government′s positioning of public hospitals, and the influencing factors of the government′s positioning of public hospitals, this paper tries to provide a theoretical basis for formulating a scientific and comprehensive reform plan of public hospitals.

Objective To investigate the effects of camel milk on immune cells in lamina propria (LP) of intestinal mucosa in mice. Methods Six male C57BL/6 mice(6-8 weeks) were randomly divided into two groups as follows: camel milk treatment group and double distilled water (DDW) control group. Samples of cells in LP of intestinal mucosa were collected. Cell counts and percentages of immune cells in LP were analyzed by flow cytometry. Levels of IL-4,IL-10,IL-17 and IFN-γ in the supernatants of cell cul-ture were measured by ELISA. Results Compared with the DDW control group, the camel milk treatment group showed increased percentage and absolute number of CD4+T cells as well as IFN-γ-secreting CD4+T cells in LP of intestinal mucosa(P<0.05). Moreover,significantly enhanced expression of IFN-γ and sup-pressed secretion of IL-4 were found in the camel milk treatment group (P<0.05). Conclusion Camel milk can promote the proliferation of CD4+T cells and enhance the secretion of IFN-γ,indicating that camel milk regulates the proliferation and cytokine secretion of immune cells in LP of intestinal mucosa in healthy mice.