OBJECTIVE:To study the time-effect and dose-effect of paeonol on the apoptosis of knee osteoarthritis(OA)artic-ular chondrocyte in rabbits and the mRNA expression of its related protein Bcl-2 and Bax. METHODS:60 big-ear rabbits were ran-domly divided into normal (normal saline) group,model (normal saline) group,paeonol high-dose,medium-dose and low-dose groups and triamcinolone acetonide(positive drug)group,with 10 rabbits in each group. Except for normal group,OA model was induced by right knee anterior cruciate ligament (ACLT) and the medial meniscus 1/3 resection in those groups. After modeling, different doses of paeonol(0.8,0.4,0.2 mg/kg),triamcinolone acetonide 0.2 mg/kg were injected into right articular cavity twice a week. 4 weeks and 8 weeks after administration,articular cartilage specimens were collected. Ultrapathological structure changes of articular chondrocytes were observed by electron microscope. Apoptosis of cartilage cell was observed by TUNEL and apoptotic index was calculated. mRNA expression of apoptosis related genes of Bcl-2 and Bax in articular cartilage tissue of rabbits were de-tected by in situ hybridization technique. RESULTS:Compared with normal group,articular chondrocyte of model group showed early and middle stage apoptosis morphology change after 4 and 8 weeks,and apoptosis index increased significantly and the mRNA expression of Bcl-2 and Bax was up-regulated (P<0.01);4 and 8 weeks later after administration,compared with model group,apoptosis index decreased and mRNA expression of Bax was down-regulated in paeonol groups,while mRNA expression of Bcl-2 was up-regulated(P<0.05 or P<0.01). Electron microscopy ultrastructural observation showed articular chondrocyte of pae-onol high-dose and middle-dose groups were in early stage of apoptosis.CONCLUSIONS:Paeonol can slow down articular chondro-cyte degeneration and destroy in OA model rabbits in time and dose dependently. Its mechanism may be associated with expression up-regulation of Bcl-2 and expression down-regulation of Bax.

OBJECTIVE To learn the practical experience of medical insurance payment standards adjustment in Japan and South Korea， which will serve as a reference for the improvement of simple renewal mechanism in China. METHODS Retrieving relevant literature from CNKI and related policy documents from official websites of Japan and South Korea， the medical insurance payment standards adjustment practice in Japan and South Korea would be elucidated from 2 perspectives of adjustment criteria and formulas， and then were compared with the current simple renewal mechanism in China to clarify the areas where simple renewal mechanism in China can be optimized and propose several suggestions. RESULTS & CONCLUSIONS In terms of adjustment methods， Japan and South Korea were similar to China. For excessive drugs， the reduction rate of drugs was calculated based on the situation of excess and adjustments were implemented； however， there were differences in the specific adjustment criteria and formulas. Japan and South Korea adopted a linear price reduction approach for drugs with significant oversupply， while China adopted a gradient price reduction approach for drugs with both current and expected oversupply. The results of the comparative analysis show that China has initially established simple renewal mechanisms that are in line with the national conditions and the actual medical insurance situation， and has taken some innovative measures， including considering the current and expected oversupply of drugs and introducing a halving mechanism in the adjustment formula. However， there are also certain shortcomings， such as a relatively single set of indicators for adjusting conditions and a too broad range of gradient price reduction in adjustment formulas， which fail to fully reflect the market-oriented mechanism of “volume for price”. It is recommended that China’s medical insurance department increase consideration of drug fund expenditures， refine the gradient price reduction range of adjustment formulas， increase policy preferences for special category drugs when adding new indications， and further improve the mechanism for simple renewal.