OBJECTIVE:To promote the implementation of drug“zero profit”,and ensure the interests of both doctor and pa-tient. METHODS:Through introducing the related information of drug management and compensation mechanism of drug“zero profit”,the advices were put forward for the heavy financial burden,shortage of hospital income and medical accessibility,etc. RESULTS&CONCLUSIONS:Drug“zero profit”could promote the reform of public hospital. If both doctor and patient could ob-tain benefits,it is very important to strictly enforce compensation mechanism and increase the government investment. Meanwhile, medical service price should be appropriately adjusted to reflect technical value,knowledge value and risk value of medical staff;preparyment of the total amount should be propeled by project,disease,head and other payment methods to control unreasonable medical expenses growth;mechanical of the hospital operating service should be improved to consciously reduce the dependence on drug profits.

Based on recent cellular architectural studies on the bed nuclei of the stria terminalis (BST) in the rat by Ju et al, we studied vasoactive intestinal polypeptidelike immunoreactivity (VIP-LI) in the BST using PAP and ABC techniques. (1) Compared with VIP-LI cells, the VIP-LI terminals were more abundant and concentrated. At the periphery of the oval nucleus and in the juxtacapsular nucleus, there was a dense accumulation of VIP-LI terminals. Less densely innervated areas were the part above the anterior commissure in the anterior lateral area and the central part of oval nucleus. The fusiform nucleus and rostral part of the anterior ventral area contained moderate amount of VIP-LI terminals. The principal nucleus, interfasicular nucleus, posterior dorsal nucleus and dorsal nucleus, were devoid of VIP immunoreactivity. VIP-LI fiber branches were sometimes seen going along the vessels in the BST. (2) VIP-LI cells were usually distributed in areas where the terminals were relatively sparse. In the central part of the oval nucleus, the VIP-LI cells were most concentrated, though the total number of it was less than that in the caudal part of the anterior dosal area, They were usually small fusiform in shape, however some were trangular or multipolar.

Using immunohistochemical method in the present study we examined the changes of the CGRP-LI nerve fibers in the anterior pituitary (AP) of the rat after adrenalectomy. 60 male adult rats were divided into 5 groups at random, i.e., normal, sham-operated, adrenalectomized (AdX) plus hydrocortisone, normal plus hydrocortisone and AdX groups. There were some of CGRP-LI nerve fibers sparsely and unevenly distributed in the normal rat AP. The fibers which had some varicosities and varied in their thickness could occurred either individually or in plexus. The quantity of CGRP-LI nerve fibers increased in number, length, branches and the density of the varicosities. The extent of their distribution was also enlarged. With a Leitz computer-assisted image analyzer the quantity of the CGRP-LI nerve fibers in the 5 groups was measured and the results showed that the amount of CGRP-LI nerve fibers in AdX group was significantly higher than those in all the other groups (P

BACKGROUND:The anatomical morphology of the distal end of humerus is an important factor for restricting the treatment of fracture at the site, also for designing and improving of internal fixator and prosthesis. It is very significant to determine the anatomical parameters of the distal end of humerus for correcting the deformation, fixation of internal fixator and replacement of prosthesis.OBJECTIVE: To measure 17 anatomical parameters of the angles and structural width or depth related to the distal end of the humerus, verify their fitness with bone after implantations of internal fixator and prosthesis, and identify the association between the characteristics and the mechanical properties of the internal fixator and prosthesis.DESIGN: A repetitive measurement and comparative observation.SETTING: Affiliated Hospital of Nantong University.MATERIALS: The experiments were carried out in the Trauma Research Room, Affiliated Hospital of Nantong University from October 2005 to February 2006. Fifty-four pairs of humerus samples from adult antisepsis corpses were randomly selected (provided by the Department of Human Anatomy, Medical College of Nantong University), including 30 pairs from males and 24 pairs from females, while those with deformation and degeneration of elbow joint were excluded. METHODS: The soft tissues adhered to the humerus samples were all rejected, and the anatomical parameters of the distal end of humerus were measured with slide gaud (0.01 mm in precision, produced by Shanghai Measuring and Cutting Tool Works), calipers and goniometer. ① Measurement of angles related to the distal end of humerus: The measured parameters included the anteverted angle of the distal humerus, the lateral rotation angle of humerus trochlea,the anteverted angulation of humerus capitulum, the anteverted angulation of humerus trochlea, the condyle-shaft angle of humerus, and the internal rotation angle of the line of lateral-medial humerus epicondyle. ② Measurement of structural width and depth related to the distal end of humerus: The measured parameters included the horizontal diameter of the anterior end of humerus trochlea, the horizontal diameter of the inferior end of humerus trochlea, the sagittal diameter of humerus trochlea, the width between medial epicondyle and external epicondyle, the width between medial trochlea and lateral capitulum, the width of olecranon fossa, the depth of olecranon fossa, the width of medial epicondyle, the depth of sulcus for ulnar nerve, the width of humerus capitulum, and the sagittal diameter of humerus capitulum..MAIN OUTCOME MEASURES: Results of the angles and structural width or depth related to the distal end of the humerus.males and females in the anteverted angle of the distal humerus [(35.62±5.21)°, (96.22±5.29)°], the lateral rotation angle of humerus trochlea [(5.22±1.15)°, (5.46±1.33)°], the anteverted angulation of humerus capitulum [(48.35±8.78)°,(49.65±9.12)°], the anteverted angulation of humerus trochlea [(33.08±7.15)°, (34.45±7.52)°], the condyle-shaft angle of humerus [(80.12±5.22)°, (80.17±5.45)°], and the internal rotation angle of the line of lateral-medial humerus humerus: There were no significant differences between males and females in the horizontal diameter of the anterior end of humerus trochlea [(21.40±4.21), (21.12±4.34) mm], the horizontal diameter of the inferior end of humerus trochlea [(23.54±4.52), (23.31±4.43) mm], the sagittal diameter of humerus trochlea [(23.91 ±4.85), (23.55±4.63) mm], the width between medial epicondyle and external epicondyle [(58.23±6.44), (55.32±6.55) mm], the width between medial trochlea and lateral capitulum [(45.36±5.21), (42.15±5.03) mm], the width of olecranon fossa [(24.56±4.25), (25.34±4.42) mm],the depth of olecranon fossa [(13.43±2.52), (12.95±2.13) mm], the width of medial epicondyle [(14.35±3.32), (13.02±2.96) mm], the depth of sulcus for ulnar nerve [(8.53±2.96), (7.90±2.54) mm], the width of humerus capitulum [(18.05±2.87), (16.51±2.75) mm], and the sagittal diameter of humerus capitulum [(19.59±3.84), (19.12±3.55) mm] (P＞0.05).CONCLUSION: The anatomical parameters of the distal end of humerus should be considered in performing correction of elbow joint, internal fixation and prosthesis replacement in order to get better recovery of elbow joint function.

Template direct dye-terminator incorporation with fluorescence-polarization (TDI-FP assay) is a technology for genotyping single nucleotide polymorphisms (SNPs). To apply this method in analyses of A647G variation in human papillomavirus (HPV) 16 E7 gene from HPV 16-positive cervical tissues, a total of 91 and 49 HPV 16-positive DNA samples obtained from women with cervical cancer and normal/inflamed cervices living in Shaanxi in northwest China were subjected to the partial E7 gene PCR with nucleotide (nt) 647 in the products. Then, the oligonucleotide probe designed to anneal immediately to nt 647 was hybridized to the template within the PCR amplicons, and extended specifically by TAMRA-ddTTP or R110-ddCTP directed by the base at nt 647. The increasing FP values were read and the base at nt 647 was identified. The prevalence of nt 647 A→G was 35.71% (50/140). The variation 647G detected in 42.86% (39/91) of women with cervical cancer was significantly higher than 22.45% (11/49) detected in those with normal/inflamed cervices (x2 = 5.778, P = 0.016). The odds ratio (OR) between these two groups was 2.59 (95% confidence interval=l.17～5.71). The results demonstrate that TDI-FP method can be potentially applied in analysis of interest point mutations in HPVs. The incidence and risk implication of HPV 16 A647G variant infection in Shaanxi, China, displays significant geographic difference from other areas. The HPV 16 with E7 gene A647G point mutation appears to have a higher risk for invasive cervical cancer in women living in Shaanxi.

Objective:To summarize the development of the HIV/AIDS designated hospital system, analyze the main issues and explore solutions for this system. Methods:184 leaders/experts of three levels of healthcare facilities ( provinces, cities and counties) from 30 provinces engaged in AIDS prevention and control for over five years, and 2,432 people living with HIV/AIDS(PLWHA) from seven provinces were investigated through two different question-naires. Results:According to the staff responses, the issues of surgery and hospitalization are difficult and outstand-ing for PLWHA due to the current designated hospital system with scores of 6. 49 in severity. Of the ten largest prob-lems, ranked third is the need for improved AIDS prevention and control. 2 367 (97. 3%) PLWHAs had an aware-ness of the designated hospitals, 1,376 received treatment in the designated hospitals, and 85. 5% believed that the illness was effectively treated, while 9. 0% thought that the medical technology of the designated hospital was limited;18 . 7% of hospitalized HIV/AIDS patients or those who received surgery experienced prevarication by the non-des-ignated hospitals. Policy analysis shows that China’s designated hospital system for PLWHA has developed gradually with the characteristics of periodic and temporary changes. Conclusion:The designated hospital system for PLWHA in China has played an important role, but there are still several problems. The government should improve the existing system by strengthening the comprehensive medical service capacity of designated hospitals, improving the mechanism of consultation and referrals, coordinating the non-designated hospitals to provide technical support, reducing dis-crimination and fear from medical staff against HIV/AIDS, decreasing the risk of occupational exposure, and enhan-cing the communication among hospitals, CDCs and patients.

Objective:To explore epidemiologic features of primary aldosteronism (PA) in northern Jiangsu and using plasma aldosterone/renin activity ratio (ARR) combined plasma aldosterone level to screen PA patients among pa-tients with hypertension .Methods:A total of 2014 inpatients and outpatients with hypertension were collected from our hospital .Radioimmunoassay was used to measure plasma levels of renin and aldosterone and blood biochemical indexes ,then ARR was calculated .PA was diagnosed when ARR>240 and aldosterone>150 pg/ml .Results:A to-tal of 239 patients (11. 87% ) were complicated with PA among the 2014 patients with hypertension ,and it occupied 23.69% (145/612) among patients with refractory hypertension .Compared with pure hypertension group ,there were significant reductions in renin activity [ (2.18 ± 2.54) ng?ml-1 ?h-1 vs .(0.68 ± 0.49) ng?ml-1 ?h-1 ] and serum potassium level [ (3.96 ± 0.45) mmol/L vs .(3.54 ± 0.45) mmol/L] ,significant rise in aldosterone level [ (132.99 ± 104.25) pg/ml vs .(272.55 ± 154.68) pg/ml] and ARR [ (118.40 ± 109.4) vs .(463.19 ± 251.85)] ,P<0.05 or <0.01 ,and significant reduction in onset age of hypertension [ (49.37 ± 9.31) years vs .(39.69 ± 7.59) years] ,P<0.01. Patients complicated with hypokalemia occupied 33.47% among PA patients ,linear correlation a-nalysis indicated that serum potassium level was correlated with aldosterone level (r= -0.706 , P=0.001) .Conclu-sion:In northern Jiangsu ,PA occupies 11.87% among patients with hypertension and it occupies 23.69% among pa-tients with refractory hypertension .Therefore ,plasma ARR should be regularly detected to screen PA patients in patients with hypertension ,especially those with refractory hypertension .

Objective To analyze the clinical and pathological characteristics of children with lupus nephritis(LN).Methods The data of 116 inpatients from Mar.2000 to Nov.2008 with LN were retrospectively analyzed.The clinical,immunochemical and pathological data were recorded.Renal tissue was observed by light microscopy and electron microscopy after HE,PAS,Masson and PASM staining according to WHO standards.Follow-up results showed complete remission,partial remission,disease activity,renal insufficiency and death.Results Of the 116 cases of LN,there were 27 male and 89 female with a ratio of male to female 1.03.3,and the mean age was(12.0?2.2) years.The incidence of nephrotic syndrome was 63.8 %(74 cases),and acute nephritis was 21.5%(25 cases).Class Ⅳ LN was the most frequent type(14 cases,50%) and classⅢ was next(25 cases,21.5%).In view of the outcome,rapidly progressive glomerulonephritis and class Ⅳ LN were the worst.LN was initially controlled in 96.5% of the patients.Relapses of LN were most caused by the intermittent treatment.Totally 32 cases showed different renal injury,and 6 cases progressed to death.Conclusions Renal biopsy is important to diagnosis,treatment and prognosis evaluation of LN.Long and regular treatment is important for children with LN.

OBJECTIVE:To compare the differences in the contents of water-soluble total protein,total phenolic acid and total polysaccharides among the water decoctions of crude Cibotium barometz and processed products and to illuminate the effect of pro-cessing on 3 kinds of components of C. barometz. METHODS:UV-visible spectrophotometry was adopted to determine the con-tents of water-soluble total protein,total phenolic acid and total polysaccharides in the water decoction of crude C. barometz and 4 processed products,namely sand-scorch C. barometz,yellow wine C. barometz,salt C. barometz and steamed C. barometz,at wavelengths of 590,760 and 489 nm respectively. RESULTS:The contents of water-soluble total protein in 5 samples were 4.03%,3.32%,3.13%,3.33% and 3.49%,those of total phenolic acid therein were 0.25%,1.34%,1.38%,2.34% and 1.41%,and those of total polysaccharides therein were 28.56%,36.06%,45.21%,49.60% and 49.01%,respectively. CONCLU-SIONS:All above processing methods have an effect to some degree on the contents of the 3 kinds of components of C. barometz, where the contents of water-soluble total protein are lower after processing,while those of total phenolic acid and total polysaccha-rides are higher thereafter.

Objective To explore the effects of expressing human ciliary neurotrophic factor (hCNTF) mediated by retroviral vector in olfactory ensheathing cells(OECs) on the survival and neurite outgrowth of cultured neurons. Methods S\|hCNTF fragment was digested with endonucleases(Kpn I and Xba I) from pcDNA\-3\|S\|hCNTF plasmid and cloned into pRev\|TRE vector.The harvested pRev\|TRE\|hCNTF was identified and transfected with pRev\|Tet\|On into ecotropic Ecopack\|293 cells,resulting in 2 retroviral supernatants(pRev\|TRE\|hCNTF and pRev\|Tet\|On).Primarily cultured rat olfactory ensheathing cells(OECs) were co\|infected with the 2 retroviruses,and induced to secrete hCNTF with different concentrations of doxycline.The secreted hCNTF in OEC culture supernatant was detected with Western\|blot.Dorsal root ganglion (DRG) from a postnatal rat of 2 days was co\|cultured with CNTF\|modified OECs,and the supernatant was used to culture retinal ganglion cells(RGCs).Following ?\|tubulin immunocytochemical staining,the length of DRG neurites were measured,while the numbers of surviving RGCs were counted. Results 1.Individual 630bp and 400bp fragments were digested from pRev\|TRE\|S\|hCNTF expression vector with endonucleases(Hind Ⅲ and BamH Ⅰ),and respected direction and integration of hCNTF cDNA which inserted pRev\|TRE vector were identified; 2.The expression of 24kD CNTF proteins in CNTF\|modified OEC culture supernatant was positively\|correlated with the concentration of doxycline,while no such protein expression was detected in the control groups; 3.The number of surviving RGCs in CNTF\|modified OECs group(41\^34?5\^4) was significantly higher than those in unmodified OEC(23\^15?4\^7),OECs(24\^55?5\^8) and blank(16\^8?6\^5) groups;and 4\^The neurites of DRG were longer (660?67?m) and denser in CNTF\|modified OECs group,as compared with unmodified OECs(418?45?m),Mock+OECs(400?65?m) and blank (0?m) control groups.No process migrated and grew from the tissue mass in blank group.Conclusion\ hCNTF can be expressed in OECs with a doxycline concentration\|dependent manner after transfected via pRev\|TRE\|S\|hCNTF vector,and possesses a marked enhancing effect on the survival and neurite outgrowth of cultured neurons.[