To establish the control model of medical insurance in hospitals, so as to improve the effectiveness of internal operation for medical insurance fund. Methods: Using the utility theory to establish the control model, with which the medical service provider is individual rationality constraints and incentive compatibility constraint. Results: The bonus coefficient and punishment coefficient can be calculated by means of evolutionary programming. Conclusion: The control model of hospital internal medical insurance fund is useful in controlling the medical insurance expense, it also provides the guidance and references for performance management and internal operation.

After the status quo of ESI-covered pharmacology, toxicology and clinical medicine in domestic universities of traditional Chinese medicine was described, the papers and highly-cited papers published by these universities, total citations, citations of each paper were ranked and compared.The related problems and development tendency of different subjects were analyzed with suggestions put forward for the construction of first class subjects in domestic colleges and universities of traditional Chinese medicine.

Objective: To retrospectively characterize and analyze the thyroid ultrasound images of thyroid cancer patients, to classify thyroid nodules according to thyroid imaging reporting and data system (TI-RADS), and to evaluate the diagnostic value of TI-RADS. Methods:Clinical data of 160 thyroid cancer patients with 235 nodules from September 2008 to August 2011 were retro-spectively analyzed. All patients underwent conventional color Doppler ultrasonography to evaluate the size, number, shape, boundary, and extent of lesions and blood distribution of the nodules. All nodules were analyzed according to TI-RADS classification and scored to evaluate the diagnostic value of TI-RADS. Results:Among 176 malignant nodules, 144 (81.8%) had lesions showing a mass of irreg-ular boundary with no envelope and halo, 152 (86.4%) were inhomogeneous hypoechoic or slightly hypoechoic, or 144 (81.8%) exhibit-ed microcalcification. TI-RADS scores of 4 or 5 and 2 or 3 were obtained in 160 (90.91%) and 16 (9.09%) of the malignant nodules, re-spectively. Conclusion:Thyroid ultrasound sonogram of ill-defined, irregular shape, hypoechoic or slightly hypoechoic mass, microcal-cification within the mass, and rich blood flow is an important index for the diagnosis of thyroid cancer. Thyroid nodules with a TI-RADS score 4 or 5 have higher possibility for cancer. Therefore, TI-RADS has a significant diagnostic value for thyroid cancer be-fore operation.

To study the chemical constituents of Dipsacus asper, chromatographic methods such as D101 macroporous resin, silica gel, octadecylsilyl (ODS) column chromatographic techniques and preparative HPLC were used, and five compounds were isolated from 70% (v/v) ethanol extract of the plant. By using spectroscopic techniques including 1H NMR, 13C NMR, 1H-1H COSY, HSQC, HMBC and TOF-MS, the compounds were identified as 3beta-hydroxy-24-nor-urs-4 (23), 12-dien-28-oic acid (1), ursolic acid (2), oleanolic acid (3), 3-O-alpha-L-rhamnosyl(1 --> 3)-beta-D-glucopyranosyl (1 --> 3)-alpha-L-rhamnosyl (1 --> 2)-alpha-L-arabinopyranosyl hederagenin 28-O-beta-D-glucopyranosyl (1 --> 6)-beta-D-glucopyranosyl ester (4), 3-O-[beta-D-xylopyranosyl (1 --> 4)-beta-D-glucopyranosyl (1 --> 4)] [alpha-L-rhamnosyl(1 --> 3)]-beta-D-glucopyranosyl (1 --> 3)-alpha-L-rhamnosyl(1 --> 2)-alpha-L-arabinopyranosyl hederagenin (5), separately. Among them, 1 is a new compound, and 2 is isolated from this plant for the first time.

Objective To establish a RP-HPLC method investigate the processing technique and mechanism of Eucommiae Cortex.Methods The RP-HPLC method was applied to simultaneously determining six ingredients,geniposidic acid,geniposide,genipin,chlorogenic acid,(+)-pinoresinol-di-β-D-glucopyranoside,and(+)-syringaresinol-di-β-D-glucopyranoside,in the different processed barks of Eucommia ulmoides.Results The valid method with good accuracy could be well used to study the processing technique of E.ulmoides;Besides,target ingredients in E.ulmoide were decreased within 6 h when they were processed.Conclusion Established RP-HPLC is a reliable method which could be used to research the processing technique of the barks ofE.ulmoides.Moreover,the result of this study could be provided with significant evidence of processed barks of E.ulmoides.

Objective To investigate the environmental impact of the Japanese Fukushima No.1 nuclear power plant accident on radiation levels in some areas of Liaoning province.Methods The emergent monitoring was performed by detecting atmosphere aerosols,precipitations,drinking water,vegetables,milk and seafood by gamma spectrometry analysis and gross activity measurements.Results The fission radionuclides of 131I,134Cs and 137Cs were detected in atmosphere aerosols 20 d after nuclear accident.The rad ionuclides of 131I,134Cs and 137Cs were found existing in atmosphere for 25,4 and 6 d,respectively,with the highest concentrations of 4.6 × 10 3,2.9 × 10-4 and 4.2 × 10-4 Bq/m3,respectively.The man-made fission radionuclides could not be detected in vegetablcs,drinking water and milk from Shenyang city and seafood from Dandong city.Conclusions The atmosphere might be slightly contaminated in Liaoning province due to the nuclear accident,whereas the vegetables,milk and drinking water not contaminated.

Objective To study changes of humoral immunity of the premature infants in different pathological conditions and detect the reason of the deficiency of humoral immunity in premature infants .Methods Two hundred and forty-six prematur were enrolled and 30 healthy neonates were selected as control group .The percentages of IgG ,IgA ,IgM and comp lement C3 ,C4 were detected by full automatic biochemical analyzer .Results The results showed that IgG ,IgM ,IgA ,C3 and C4 in the premature in-fants were lower than those in the normal term infants and there was a highly significant difference with the decrease of fetal age . IgG ,IgM ,IgA ,C3 and C4 of the group of the premature infants ranging from 32 to 36 weeks had reduced in different degree ,rela-tive to the groups of BW <2 000 g ,hypertension during pregnancy ,cesarean section(P<0 .05) .Conclusion The results showed that function of humoral immunity in the premature infants was depressed and low gestational age ,low birth weight ,cesarean sec-tion and hypertension during pregnancy may be the leading cause of the deficiency of humoral immunity .

Objective To investigate the role of inducible nitric oxide synthase (iNOS) in reduction of myocardial ischemia-reperfusion (I/R) injury by sufentanil preconditioning in rats. Methods Thirty adult male SD rats, weighing 250-330 g, were randomly divided into 5 groups ( n =6 each): sham operation group (group S),I/R group, sufentanil preconditioning group (group SF), sufentanil preconditioning + a specific inhibitor of iNOS S-methyl thiourea (SMT) group (group SF+ SMT) and S-methyl thiourea group (group SMT). In I/R,SF,SF+SMT and SMT groups, myocardial I/R was produced by occlusion of left anterior descending coronary artery for 30 min followed by 120 min reperfusion. Group SF received 30 min infusion of sufentanil 120 μg/kg via caudal vein 24 h before ischemia. Group SF + SMT received infusion of sufentanil 120 μg/kg via caudal vein 24 h before ischemia and then SMT 10 mg/kg was injected 10 min before ischemia. In group SMT, SMT 10 mg/kg was injected 10min before ischemia. MAP and HR were recorded at 30 min before ischemia, at 30 min of ischemia and at the end of reperfusion. The rate-pressure product (RPP) was calculated. Arterial blood samples were obtained immediately at the end of reperfusion to determine the plasma concentration of NO. Then the animals were sacrificed and myo cardial tissues were obtained to determine the area at risk (AAR), infarct size (IS) and iNOS expression. IS/AAR was calculated. Results Compared with group S, MAP and RPP were significantly decreased, while IS/AAR was significantly increased at 120 min of reperfusion in the other four groups, and MAP and RPP were significantly decreased at 30 min of ischemia in I/R and SMT groups ( P ＜ 0.05). Compared with group I/R, no significant change was found in HR, MAP and RPP in SF, SF + SMT and SMT groups, and in IS/AAR and plasma NO concentrations in SF + SMT and SMT groups ( P ＞ 0.05), but IS/AAR was significantly decreased, and the plasma NO concentration and iNOS expression were significantly increased in group SF ( P ＜ 0. 05). Conclusion iNOS is involved in reduction of myocardial I/R injury by sufentanil preconditioning in rats.

Objective To evaluate the effect of remffentanil postconditioning on myocardial ischemiareperfusion (I/R) injury in patients undergoing open heart surgery under CPB.Methods Thirty patients (ASA grade Ⅱ or Ⅲ, NYHA class Ⅰ or Ⅱ ) of both sexes aged 18-45 yr undergoing repair: of ventricular septal defect and/or atrial septal defect under CPB were randomly divided into 2 groups ( n = 15 each): control group (group C)and remifentanil postconditioning group (group R). Anesthesia was induced with midazolam, sufcntanil, propofol and rocuronium. The patients received 5 min infusion of remifentanil at 4 μg · kg- 1 · min - 1 8 min before aortic unclamping in group R, while the patients received equal volume of normal saline in group C. Blood samples were obtained from the right internal jugular vein for determination of plasma concentrations of cardiac troponin-I (cTnI)and MDA and activities of CK-MB and SOD before induction of anesthesia (baseline) and at4, 8, 24 and48 h after aortic unclamping. Results The plasma concentrations of cTnI and MDA and activity of CK-MB were significantly lower, while the plasma SOD activity was significantly higher at 4 and 8 h after aortic unclmping, and the plasma concentration of MDA was significantly lower at 24 h after aortic unclamping in group R than in group C ( P ＜ 0.05 ). Conclusion Remifentanil postconditioning can attenuate myocardial I/R injury in patients undergoing open heart surgery under CPB through inhibiting lipid peroxidation.

Objective To evaluate the effect of emulsified isoflurane preconditioning on myocardial iachemia-reperfusion (I/R) injury in rabbits.Methods Thixty-two male New Zealand white rabbits weighing 2.5-3.0 kg were randomly divided into 4 groups(n=8 each):group Ⅰ I/R;group Ⅱ isoflurane preconditioning (group Ⅰ);group Ⅲ emulsified isoflurane preconditioning (group EI) and group Ⅳ intralipid (group INT).Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 180 min of reperfusion.After 30 min of post-preparation equilibration.the animal inhaled 3%isoflurane for 30 min followed by 15 min washout in group Ⅰ(group Ⅱ);8% emulsified isoflurane 8-10 ml was injected iv at 1 ml/s followed by continuous infusion at 6-8 ml·kg-1·h-1,maintaining end-tidal isoflurane concentration at 1.28% for 30 min in group EI (groupⅢ);30% intralipid 9 ml was injected iv at 1 ml/s fullowed by continuous infusion at 7 ml·kg-1·h-1 for 30 min in group INT (group IV).HR and BP were monitored and recorded at 30 min of post-preparatory equilibration(T0),before ischemia(T1),at the beginning of ischemia(T2),at 30 min ofischemia(T3),60,120 and 180 min of reperfnsion(T4,5,6).HR-SP product (RPP) was calculated.Infarct size (IS) was determined by TIC staining.Blood samples were taken from carotid artery at T6 for determination of serum CK and LDH activities and IL-6 and IL-10 concentrations.Results HR,MAP and RPP were decreasing during T2-6, but there was no significant difference in HR, MAP and RPP among the 4 groups.The infarct size was signigicantly smaller, serum CK and LDH activities and IL-6 concentration were significantly lower while serum IL-10 concentration was significantly higher in group I and EI than in group I/R and INT.Conclusion Emulsified isoflurane preconditioning can attenuate myocardial I/R injury by inhibiting inflammatory response.