Medical security fund is the core of medical security system. The traditional system of medical security fund management has enabled various governmental departments to play positive roles, and has controlled the growth of expenditure. Since the Reform and opening-up, along with the reform of medical security system, a scientific and reasonable fund-raising mechanism has been established, the management of medical security fund has been societalized, and the supervision and regulation mechanisms of registered healthcare agencies have been initially established, all of which further promote the reform and development of healthcare system. But the existing management system is not perfect, and a medical security fund system which adapts to China's national conditions and the needs of the development of healthcare system must be further explored.

OBJECTIVE:To explore the methods of clinical pharmacists providing pharmaceutical care for a patient with N-methyl-D-aspartate receptor(NMDAR)encephalitis complicating with multiple organ infections. METHODS:Taking one clinical case as breakthrough point,the points of pharmaceutical care provided by clinical pharmacists for NMDAR encephalitis complicat-ing with multiple organ infections were analyzed,so as to put forward the suggestions in the field of antibiotics selection,medica-tion approach based on pharmacokinetics,ADR disposal and nutrition support. RESULTS:Clinical pharmacists applied pharmaceuti-cal care to resolve ADR as abnormal liver enzyme timely,and the symptom had been improved gradually. Then the patient was dis-charged from the hospital. CONCLUSIONS:Clinical pharmacists provide pharmaceutical care and screen the possible risk of drug use to avoid the occurrence of severe ADR.

Objective To investigate the effects of renal denervation (RDN) on left atrial fibrosis in rats with chronic heart failure.Methods Sixty healthy male Sprague Dawley rats were randomly assigned to control group (n =10,intraperitoneal injection with 5 mg/kg normal saline daily for 3 consecutive weeks),sham group (n =25) and RDN group (n =25).Rats in sham and RDN group were intraperitoneally injected with 5 mg/kg isoproterenol daily for 3 consecutive weeks.RDN and sham RDN procedure was implemented at week 5.The renal arteries and veins were not isolated and the nerves were left intact in sham group.The experiment ended at week 10.Cardiac function,diastolic interventricular septal thickness (IVSD) and left atrial dimension (LAD) were evaluated by echocardiography at baseline,week 5 and 10.The rats of all three groups were sacrificed at week 10 and the left atrial tissue was used for following analysis:fibrosis was detected by Masson staining,plasma BNP was measured by ELISA kit,the protein expression of Ang Ⅱ,TGF-β1,MMP2 and collagen Ⅰ was determined by Western blot.Results (1) Cardiac function:compared with control group,LVEF decreased (P ＜ 0.01),IVSD (P ＜ 0.01) and LAD (P ＜0.01) increased significantly in the sham and RDN group at week 5.Compared with sham group at week 10,LVEF and IVSD significantly improved (P ＜ 0.05) and LAD tended to be smaller (P ＞0.05) in RDN group.(2) The degree of left atrial tissue fibrosis:Masson staining (collagen volume fraction,CVF) showed significantly decreased fibrosis of left atrial tissue in RDN group compared with that in sham group (P ＜ 0.01).(3) Plasma BNP level:ELISA assay revealed that plasma BNP in sham group was significantly increased compared with that in control group (P ＜ 0.05) and was similar between RND group and control group at week 10.(4) Protein expression of AngⅡ,TGF-β1,MMP2 and collagen Ⅰ in rats left atrial:Western blot analysis demonstrated that the expression of Ang Ⅱ,TGF-β1,MMP2 and collagen Ⅰ was significantly down-regulated in RDN group compared to sham group (all P ＜ 0.05) but still significantly higher than in control group (all P ＜ 0.05).Conclusions RDN can effectively attenuate the left atrial fibrosis in rats with isoproterenol induced chronic heart failure.The attenuation of left atrial fibrosis by RDN in these rats may be attributed to improved cardiac function and downregulated pro-fibrogenic factors (Aug][,TGF-β1,MMP2 and collagen Ⅰ).