The paper analyzed the impact of the trial for "lump-sum prepayment practice of medical insurance" on tertiary hospitals in Shanghai initiated by Shanghai Medical Insurance Bureau since 2009. Based on the analysis, the authors recommended that the hospitals should adapt to the changes by raising quality of care, improving cost accounting, informationizing and refining medical insurance information management, as well as controlling expenses on a rational basis. These approaches will help them adapt to and promote the ongoing health reform in China.

Objective To establish the fingerprints of 20 batches of Lavandula Angustifolia by HPLC. Methods The determination was performed on a Phenomenex ODS-A column (250 mm× 4.6 mm, 5 μm). The mobile phase was in gradient elute mode with a mixture consisting of acetonitrile and 0.036 mol/L phosphate acid solution. The flow rate was 1.0 mL/min. The temperature was 30 °C. The determine wavelength was 350 nm. The fingerprints of 20 batches of Lavandula Angustifolia were compared and classified by similarity evaluation, cluster analysis, and principal composition analysis. Results Totally 10 chromatographic peaks were extracted as the common peaks of Lavandula Angustifolia, and 2 peaks were identified. The similarity degrees of the 20 batches of Lavandula Angustifolia were above 0.9. All the batches of Lavandula Angustifolia were classified into 3 categories. Conclusion The method is simple and reproducible, and can be used for the standardization and quality control of Lavandula Angustifolia.

DNA methylation is closely related to the genesis and development of glioma.The CpG islands hypermethylation in promoter region of DNA repair genes,cell cycle controlling genes,apoptosis related genes,tumor suppressor genes and invasion related genes are found in glioma.Finding the specific methylation profile and molecular marker of glioma is helpful for the pathology class,early diagnosis and prognostic evalua-tion.Meanwhile,DNA methylation has the characteristic of reversibility,which may provide new ways for the treatment of glioma.

Atherosclerosis is the most important cause of ischemic stroke. microRNAs can play an important role in the lipid metabolism, vascular inflammatory response, angiogenesis, as wel as smooth muscle cel proliferation and phenotypic conversion, etc. by regulating the functions of vascular endothelial cel s, vascular smooth muscle cel s, and mononuclear macrophages. It is closely associated with the occurrence and development of atherosclerosis. This article mainly reviews the regulatory effect of microRNAs on lipid metabolism and vascular inflammatory response in pathogenesis of atherosclerosis.

Objective To investigate the CT perfusion imaging and the pathological features on the disturbance of regional cerebral microcirculation in a pre-infarction period, and to evaluate the relationship between the astrocytes and regional cerebral microcirculation. Methods Dynamic CT perfusion imaging of the models with regional cerebral hypoperfusion and astrocytic swelling in rats was performed to assess the presence or absence of the disturbance of regional cerebral microcirculation. Then, the histopathologic examination was made for both models, respectively. The ratios of side-to-side were measured at hypoperfusion areas in the models of regional cerebral ischemia. Results Regional hypoperfusion was revealed by regional cerebral blood flow (rCBF) and mean transit time (MTT) maps in the group of hypoperfusion for 6 hours. Regional cerebral blood volume (rCBV) and time-to-peak (TTP) maps were normal in that group. The ratios of rCBF, rCBV, MTT and TTP were 0 39-0 55, 0 92-1 00, 1 20-1 50 and 1 00-1 00 respectively. Astrocytic swelling pressing the capillary wall was obvious and subtle neuronal reversible degeneration was occasionally found. TTC stain was normal. In the tACPD group of astrocytic swelling, the abnormal hemodynamic regions on rCBF and MTT maps were found. The rCBV maps of 3 rats in the tACPD group showed the area of reduced rCBV. In 2 rats of tACPD group, the areas of delayed TTP were also found. The ratios of rCBF, rCBV, MTT and TTP were 0 25-0 44, 0 70-1 01, 1 20-2 00 and 1 02-1 45 respectively. TTC stain was negative. Electron microscope study revealed remarkable swelling of astrocytes, especially endfoot processes of astrocytes around capillaries. The abnormal hemodynamic region on rCBF and MTT maps matched with abnormal extent on histopathologic examination. The rCBV and TTP maps appeared normal. Conclusion The astrocytes can react in a way faster than the neurons in the pre-infarction period, viz. astrocytic swelling. The swelling of astrocytic foot, which pressed capillary vessel, induced the disturbance of regional cerebral microcirculation, and then aggravated hypoxic ischemic state in regional brain parenchyma. Perfusion CT and its parameters' analysis may play an increasing role to delineate the reversible hypoperfusion areas in pre-infarction period. Analyzing the relationship of rCBF and rCBV is very helpful to know the status of the capillary vessels in regional cerebral hypoperfusion area.

Objective This study was to investigate the value of CT guided 125iodine implantation combining transcatheter arterial chemoembolization(TACE) to prevent digestive tract bleeding in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods Forty patients with portal vein tumor thrombus which were diagnosed to have primary hepatocellular carcinomas by diagnostic criteria of Chinese Anti-Cancer Association were collected prospectively. They were divided into the treatment group and the control group, with 20 patients in each group. The treatment group was treated by TACE for hepatic tumor and 125iodine seed implantation for portal vein tumor thrombus, while the control group was treated by TACE for hepatic tumor and only given β-blockers medicines after treatment. Intraoperative and postoperative surgery-related complications were observed. Three months after surgery, enhanced abdominal CT scanning was performed to evaluate treatment effects which were divided into complete response (CR), partial response (PR), and progressive disease (PD) and stable of disease (SD), and the local tumor control rates were calculated. The bleeding rates and mortality after 3 months, 6 months, 12 months were recorded. Treatment effects of the two groups were compared with continuously correction Chi-square test, bleeding rates were compared with Fisher test, and survival rates were analyzed with Kaplan-Meier survival curve and compared with Log-rank test. Results Overall the 40 patients were treated successfully without serious surgery-related complications. In the treatment group, there were 8 patients with PR, 6 with SD and 6 with PD, and the local control rates were 40% (8/20). In the control group, there were 1 patient with PR, 6 patients with SD and 13 with PD. The difference of the local control rates was statistically significant (χ2=5.161, P=0.023).The bleeding rates at 3, 6 and 12 months were 2, 2 and 3 cases in the treatment group, for control group they were 2, 6 and 10 cases respectively. There was no statistical difference between the 3 months and 6 months bleeding rates (P values were 1.000 and 0.235), but for 12 months bleeding rates, the difference was statistically significant (P=0.041).The 1 year cumulative survival rates of the treatment group and control group were 70% (14/20) and 40% (8/20), and the difference was statistically significant (χ2=4.675, P=0.031). Conclusion The treatment of 125iodine implantation combining transcatheter arterial chemoembolization in patients with portal vein tumor thrombus in primary hepatocellular carcinoma can reduce variceal bleeding rate and improve survival rate.

Objective PU.1 plays a key role in innate immune function in the alveolar macrophage.This study was to con-struct and identify recombinant adenovirus vectors carrying the human transcription factor PU.1 gene. Methods The recombinant shut-tle plasmid was obtained from the PU.1 gene ( SPI1) and eukaryotic expression vector that digested by restriction enzymes and connected by T4 DNA ligase.The target fragment SPI1-IRES-EGFP was amplified by PCR.The product was cloned into the intermediate pDONR221 and then recombined with the adenovirus backbone plasmid pAd/CMV/V5-DEST to form a recombinant adenovirus vector. The recombinant adenovirus vector was linearized by PacI and then transfected into human embryonic kidney (HEK293) cells to obtain the recombinant adenovirus pAD-SPI1-IRES-EGFP, which was then propagated in HEK293 cells, filtered and purified to obtain high-con-centration adenoviruses.The adenovirus titer was determined by TCID 50 assay.The PU.1 gene expression in the HEK293 cells was con-firmed by fluorescence microscopy and real-time qPCR. Results PCR amplification, restriction digestion and sequencing analysis showed the recombinant adenovirus carried the correct PU.1 gene.The final virus titer, calculated by TCID 50, was 8 ×1011 IU/mL. Green fluorescence was observed under the fluorescence microscope. Real-time qPCR confirmed that the expression of PU.1 mRNA was increased by 2189.93 folds. Conclusion The recombinant adenovirus vector carrying the PU.1 gene was constructed and obtained successfully, which could contribute to further studies of the influence of PU.1 overex-pression on the innate defense against Aspergillus fumigatus.

Objective To establish a method for the determination of nigeglanoside in seeds of Nigella glandulifera. Methods The content of nigeglanoside was determined by HPLC.The separation was performed on a C18column ( YMC-Pack ODS-A,250 mm×4.6 mm,5 μm) with a gradient elution system of acetonitrile and 0.017 5 mol·L-1acetic acid solution at the flow rate of 1.0 mL·min-1.The detection wavelength was set at 290 nm,and column temperature was 30 ℃. Results The linear range of nigeglanoside was 0.01-0.30 mg·mL-1(R2＝0.9991).The RSDs of precision,stability and repeatability were all less than 2%.The average recovery was 96.66% (RSD＝1.25%,n＝6). Conclusion The method is accurate and reproducible. It is effective in controlling the quality of seeds of Nigella glandulifera .

Objective To evaluate the clinical value of CT-guided 125I particle implantation combined with iliac artery infusion chemotherapy in treating refractory and recurrent pelvic malignant tumors.Methods A total of 35 patients with refractory and recurrent pelvic malignant tumor,who were admitted to authors' hospital during the period from January 2013 to January 2016 to receive CT-guided 125I particle implantation combined with iliac artery infusion chemotherapy,were selected and used as the study group,while other 39 patients with refractory and recurrent pelvic malignant tumor received simple 125I particle implantation and were used as the control group.The short-term and long-term curative effect,as well as the improvement of clinical symptoms,were compared between the two groups.Results The objective effective rate and the benefit rate in the study group were 60.0％ (21/35) and 85.7％ (30/35) respectively,while those in the control group were 53.8％ (21/39) and 84.6％ (33/39) respectively,the differences between the two groups were not statistically significant (P=0.594 and P=0.894 respectively).In the study group the mean disease progressionfree period was 12.2 months,which was 3.6 months longer than that of 8.6 months in the control group,the difference between the two groups was statistically significant (P=0.002).The recurrence rates in the study group and the control group were 40.0％(12/30) and 57.6％ (19/33) respectively,the difference between the two groups was statistically significant (P=0.018).The mean preoperative and postoperative KPS values in the study group were 72.4 points and 82.7 points respectively,which in the control group were 68.9 points and 79.1 points respectively;in each group statistically significant difference existed between the preoperative KPS value and the postoperative one (P=0.043 and P=0.039 respectively),however,no statistically significant difference in postoperative KPS value existed between the study group and the control group (P=0.745).Conclusion For the treatment of refractory and recurrent pelvic malignant tumors,CT-guided 125I particle implantation is an effective therapy,however,combination use of iliac artery infusion chemotherapy can reduce the incidence of tumor recurrence and prolong the disease progression-free period.

40 IU/ml were used as cut-off points.(4) TSH level was higher in subjects with positive thyroid autoantibodies than those without antibodies (P