OBJECTIVE:To study the implementation of scoring diseases payment under the control of total budget in some ar-eas of China,and provide reference for the further improvement of the payment. METHODS:Based on the operation process of scoring disease payment in the control of toal budget,the specific practices of Huaian,Nanchang,Zhongshan and Taiwan area, were compared. RESULTS:It showed differences in the control and allocation of total budget,the establishment of scoring diseas-es,the setup of adjustment coefficient,the development of balance methods,the complementary mechanism and the monitor exami-nation setting. CONCLUSIONS:Whether to classify the diseases according to diagnosis and treatment methods,how to setup ad-justment coefficient appropriately,how to reimburse the patients in stages and how to strengthen supervision are worthy of further thinking and exploring.

Objective:To observe the effect of Jianpi Xiaozhang tablets on the bile secretion in rats. Methods: Totally 60 rats were divided into 6 groups randomly. Jianpi Xiaozhang tablet suspension(high, moderate, low dosages), Shudantong suspension, Qinggan Lidan capsule suspension and 0. 5% carboxymethyl cellulose with the same volume was respectively given with intragastric ga-vage once daily for continuous 5 days. The bile was collected to detect total bile acids ( TBA) , total cholesterol and total bilirubin. Re-sults:Jianpi Xiaozhang tablets could notably increase TBA and total bilirubin in the bile (P<0. 01), and decrease the cholesterol content significantly (P<0. 01). Conclusion:Jianpi Xiaozhang tablets can promote the bile secretion.

Objective To assess the role of dynamic contrast-enhanced MRI for diagnosis and differential diagnosis of prostatic cancer. Methods Six volunteers, 32 patients with benign prostatic hyperplasia and 13 patients with biopsy-proven prostatic cancer underwent MR imaging. Dynamic MR with Gd-DTPA (gadolinium-diethylene triamine pentaacetic acid) bolus enhancement was performed followed by post-contrast T 1-weighed imaging. The signal intensive value in dynamic MRI was measured and calculated to draw the time-signal intensity curve of normal peripheral zone, prostatic cancer and benign hyperplasia. Results In dynamic MRI, the normal peripheral zone were enhanced mildly and slowly. The lesion enhancement of benign prostatic hyperplasia in 32 patients were obvious in early phase (60 s) and strengthened gradually, and then went to decrease in late phase (240 s) after peak value. The lesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase (60 s) and washed out rapidly in late phase, and the peak value was located on early phase. Conclusions In dynamic MRI, the enhancement of normal peripheral zone, prostate cancer and benign hyperplasia were different significantly. Dynamic MRI was very useful in the diagnosis and differentiation of prostate cance.

Objective To modify the techniques for establishment of an abdominal working heart transplantation model in rats and to sum up the key factors to success.Methods A total of 180 12-week old Brown Norway rats ( donor) and Lewis rats ( recipient) were used in this study:50 BN rats and 50 Lewis rats for pilot experiment, and 40 BN rats and 50 Lewis rats for the formal experiment.The rat model of working heart heterotopic transplantation was adopted and estab-lished by Wiedemann’ s mode.We transplanted the heart from BN rats to Lewis rats and analyzed the survival rate, causes of death and histological changes of the heart ( HE staining) in this experiment.Results After exercise and modification, the survival rate was increased to 77.5%, and the mean total duration of operation was 71 ±11 min, and the mean ische-mic time of the donor hearts was 34 ±5 min.Histological examination ( HE staining) of the cardiac allograft showed a mild inflammatory cell infiltration in the graft at 24 h after transplantation, indicating that the model was reliable.Conclusions A variety of factors may affect the final operation success rate in the establishment of this heart transplantation model.A-mong them, the major affecting factors include: healthy animals, donor heart protection, rapid and effective vascular su-ture, and postoperative animal management.

Objective To study the protective effect of compound raspberry seed powder on acute irradiated rat .Methods Totally forty Wistar rats were randomized divided into four groups:normal control group, radiation group, vitamin group, compound raspberry seed powder group . The drugs were intragastrically administrated for 7 days.On 8th day, the rats in each group except control were irradiated with 8 Gy X-rays.24 h after irradiation, all rats were sacrificed and its WBC, PLT, superoxide dismutases (SOD), malonaldehyde (MDA), glutathione peroxidase (GSH-PX) in serum were detected, the DNA damage in peripheral blood lymphocytes ( PBL ) was measured with the single cell gel electrophoresis technique.Results Compared with radiation alone group , the quantities of WBC, PLT, the activity of SOD, the content of MDA and the activity of GSH-PX in the vitamin group and compound raspberry seed powder group were significantly improved(F=14.869, 6.376, 7.705, 3.851, 3.134, P<0.05).The DNA damage in PBL of radiation alone group was more severe than that of other three groups ( F=5.493, P<0.05) .Conclusions Raspberry seed powder is effective in radiation protection .

Objective: In order to evaluate the effect of catastrophic disease medical assistance policy in Qingdao and provide suggestions for Qingdao policy reform.Methods: This paper selects NSCLC and liver cancer as the typical deceases to analyze the effects of the policy on patients and medical insurance institutions and finally evaluate the effect of the policy.Results: results shows that after the implementation of special medicines and special medical equipment assistance, the rate of co-paying patients decreased 40.57%, and the pressure on medical insurance institutions' expenditure was significantly reduced;while after the implementation of large cost assistance, but rate of co-paying patients only decreased 7.13%, and the pressure on medical insurance institutions' expenditure was not effectively alleviated.Conclusions: Therefore, the policy not only protects patients with catastrophic disease by greatly reducing their medical burdens, but it also achieves the fine management of medical insurance fund and increases the efficiency of the fund.

BACKGROUND:In recent years, calcium alginate dressing has been widely used in surgical hemostasis, traumatic hemostasis, postoperative nasal hemostasis and puncture site hemostasis,etc.; however, there are few reports on their hemostatic mechanisms. OBJECTIVE: To preliminarily study the hemostatic mechanism of calcium alginate dressing. METHODS: Human anticoagulant blood was respectively dropped on sodium alginate dressing, nasopore dressing and medical cotton gauze. After 2 minutes, the interaction between materials and blood was observed at the room temperature using scanning electron microscopy. Calcium alginate dressing, nasopore dressing and medical cotton gauze were added in human red blood cel suspensions respectively. After 15 minutes, the interaction between materials and red blood cels was observed using scanning electron microscopy. The red blood cels were suspended by different concentrations (10, 5, 2.5 g/L) of alginate dressing extracts. The erythrocyte sedimentation rate was observed at different time points (30, 60, 120 minutes). Platelets rich plasma was incubated with different concentrations (10, 5, 2.5 g/L) of alginate dressing extract at 37℃, then CD62P positive platelet percentage was measured by flow cytometry after 10 minutes of incubation. RESULTS AND CONCLUSION: Dense fibrin network was formed after calcium alginate dressing contacting with an anticoagulant. A large number of blood cels were recruited. There were only a smal amount of red blood cels and platelets adhesion in the nasopore dressing and medical cotton gauze groups. After the calcium alginate dressing interacting with red blood cels, red blood cel deformability was visible, with a pseudopodia-like change. The red blood cel morphology was unchanged in the nasopore dressing and medical cotton gauze groups. The calcium alginate dressing extract dose-dependently and time-dependently increased the red blood cels aggregation, comparative differences between groups was statisticaly significant(P < 0.01). The calcium alginate dressing extract dose-dependently enhanced the CD62P positive platelet percentage, comparative differences between groups was statisticaly significant (P< 0.01). These results demonstrate that calcium alginate dressing promotes hemostasis and coagulation process by releasing of calcium ions, causing red blood cel aggregation and deformation and activating platelets.

Objective:To study the effects of different processes on diosgenin content in polygonatum from Shaanxi. Methods:The content of diosgenin was determined by HPLC on a column of Woburn C18 (250 mm × 4. 6 mm, 5 μm) with the mobile phase of acetonitrile-water(90 ∶10)at the flow rate of 1.0 ml·min-1, the detection wavelength was 203 nm, the column temperature was 30℃, and the injection volume was 30 μl. Results:The linear range of diosgenin was 0. 892-5. 352 μg(r=0. 999 9), and the aver-age recovery was 99. 5% (RSD=2. 53%). The content of diosgenin was significantly various among the samples of polygonatum with different processes from Shaanxi (P<0. 05), and that in the raw slices was the highest followed by the steam samples, while that in al-cohol evaporate slices was the lowest. Conclusion:The results of the research can provide reference for the quality control and process-ing methods of polygonatum from Shaanxi.

Objective To establish a porcine allogeneic left lung orthotopic transplantation model to closely simu-late human lung transplantation.Methods Twelve Huanjiang mini-pigs were used as donors and 12 Bama mini-pigs as recipients.The left lung orthotopic transplantation was completed by the left fourth intercostal thoracotomy.At 1 h, 2 h, 4 h, 6 h, 12 h after transplantation, the left and right pulmonary artery pressure were measured, the left and right pulmonary vein blood gas was analyzed, and samples of the left and right lung tissues were taken to determine the water content and for pathological examination.Results All animals survived, and the transplanted pulmonary vein blood PaO2/FiO2 and PAP were rised along with the prolonged postoperative time, compared with those of the recipient normal lung showing a signifi-cant difference (P<0.05).With the pass of time, there were increasing edema, inflammatory cell infiltration, RBC ooze, thickening of alveolar wall in the transplanted lung tissue, and some alveolar lumen occlusion and lung tissue consolidation. The water content of the transplanted lung tissue was increased significantly compared with that in the recipient lung tissue ( P<0.05 ) .Conclusions The established method in this study provides an ideal animal model for research on lung transplantation ischemia-reperfusion injury and immune rejection mechanism.

Objective To investigate expressions of phosphorylated c-Jun N-terminal kinase (p-JNK)and P38 mitogen-activated protein kinase(p-P38MAPK)in psoriasis vulgaris lesions. Methods Tissue specimens were obtained from lesions of 30 patients with psoriasis vulgaris and normal skin of 30 healthy human controls. An immunohistochemical study and Western-blot analysis were performed to measure protein expressions of p-JNK and p-P38MAPK in these skin specimens. Results As the immunohistochemical study showed, the expressions of p-JNK and p-P38MAPK(expressed as the average optical density [AOD]value for targeted proteins)were significantly higher in psoriasis vulgaris lesions than in normal skin tissues (p-JNK: 0.663 ± 0.016 vs. 0.333 ± 0.009, t = 44.869, P < 0.001; p-P38MAPK: 0.436 ± 0.011 vs. 0.306 ± 0.010, t = 21.913, P < 0.001). Western-blot analysis also showed increased protein expressions of p-JNK and p-P38MAPK in psoriasis vulgaris lesions compared with normal skin tissues (t = 20.477, 165.084, respectively, both P <0.05). Conclusion The activation of JNK and P38MAPK may be involved in the overproliferation of epidermal cells in psoriasis vulgaris lesions.