Reform on medial service compensation mechanism,as a key point in the heahhcare system reform,runs through the entire reform process.It plays a key role for the establishment and improvement of urban medical care system,medical service system,medical management system and operating system,for its guidance and regulation effects.Such a refonn to build a scientific and perfect compensation model and mechanism will be highly significant for the smooth progress of the new round of healthcare reform and its success in the end.

Combined with practical experience in the library of China Academy of Chinese Medical Sciences,we explore the way of pre-trial and evaluation of library e-resources.We also made an evaluation on five aspects of the contents of database,the database retrieval system,database application,the effectiveness of database and data service providers,and discussed the impact of these factors on the management of electronic library resources and the significance.

The myelodysplastic syndrome (MDS),which are characterized by the presence of ineffective hematopoetic stem cells.Research on pathogenesis and related epigetics has made significant progress in recent years,more and more abnormal cytogenetics and gene mutations are used for prognosis and treatment options for MDS.In the 56th American Society of Hematology (ASH) annual meeting,lots of gene mutations were introduced.

AIM: To explore the expression of Dickkopf-1 (DKK1) in human gastric carcinoma cells, and the influences of DKK1 gene silencing on cell invasion.METHODS: The levels of DKK1 in the human gastric mucosa cell line GES-1 and gastric carcinoma cell lines MKN-45 and SGC-7901 were detected by real-time PCR and Western blot.DKK1 gene was silenced by RNA interference, which was verified by real-time PCR, Western blot and ELISA.The cell invasion ability was determined by Transwell assay, and the cell proliferation was inhibited by mitomycin C.The levels of E-cadherin, N-cadherin, vimentin and β-catenin were determined by real-time PCR and Western blot.RESULTS: The expression of DKK1 was significantly higher in MKN-45 cells and SGC-7901 cells than that in GES-1 cells, indicating that DKK1 expression was obviously increased in gastric carcinoma cells.After successful silencing of DKK1 gene in the MKN-45 cells and SGC-7901 cells, the cell invasion ability was markedly decreased in a time-dependent pattern with increased expression of E-cadherin and decreased expression of N-cadherin and vimentin, indicating that DKK1 silencing dramatically inhibited gastric carcinoma cell invasion and epithelial-mesenchymal transition (EMT).The introduction of exogenous recombinant DKK1 (rDKK1) demonstrated the promoting effect of DKK1 on gastric carcinoma cell invasion and EMT.In addition, the inhibitory effects of DKK1 silencing on gastric carcinoma cell invasion and EMT were fulfilled by down-regulating β-catenin.CONCLUSION: The expression of DKK1 is significantly increased in human gastric carcinoma cells.Silencing of DKK1 markedly inhibits gastric carcinoma cell invasion and EMT by down-regulating β-catenin.

Objective:To investigate the effect and safety of sufentanil combined with propofol for intravenous anesthesia in chil-dren undergone painless gastroscopy. Methods:Totally 120 cases of children undergone painless gastroscopy were divided into the ob-servation group (60 cases) and the control group (60 cases) according to the random number method. The observation group was given sufentanil combined with propofol for anesthesia, and the control group was given fentanyl and propofol for anesthesia. The hemodynam-ic indices at the period of T0 (before the anesthesia), T1 (1 min after the anesthesia induction), T2 (checking), T3 (2min after the checking) and T4 ( at the end of testing) were compared between the groups, and the anesthesia situation, hospitalization time, dosage of propofol, fine/excellent rate of anesthesia and adverse reactions were also observed. Results:In T1, T2 and T3, the MAP ( mean arterial pressure) , HR ( heart rate) and RR ( respiratory rate) were declined in the two groups when compared with those in T0 ( P<0. 05), and those in the observation group were higher than those in the control group (P<0. 05). The time of consciousness disap-pearance, eyes open, orientation force recovery and hospitalization in the observation group was shorter than that in the control group, and the propofol dosage in the observation group was lower than that in the control group(P<0. 05) . The excellent number and rate of the observation group were better than those of the control group (P<0. 05), and the incidence of apnea of the observation group was lower than that of the control group (P<0. 05). Conclusion: Sufentanil combined with propofol for anesthesia in children undergone painless gastroscopy has the properties of fast onset and recovery, stable hemodynamic indices during the operation and high safety, which is worthy of promoted application.

OBJECTIVE:To probe into the economic reasons accountable for government's failure in compulsive drug pricing and put forward the countermeasure on how to strengthen the effect of compulsive pricing of the government.METHODS:Economic model was applied in the deduction and demonstration.RESULTS & CONCLUSIONS:Government's failure in setting compulsive drug prices is rooted from the imperfect pricing system.To strengthen the effect of governmental drug pricing,it is necessary to establish some supporting measures such as to tighten control on drug recommenders,shift from governmental compulsive pricing to governmental authorization to avoid excessive competition,and give reasonable compensations for special drug manufacturers etc.

OBJECTIVE:To discuss the reasons of false drug advertisement,and to suggest the countermeasures against it.METHODS:The reasons of false drug advertisement were analyzed by using the knowledge of law,governmental admin?istration and economy.RESULTS&CONCLUSION:The countermeasures against false drug advertisement were suggested.Firstly,the regulations on defining false drug advertisement should be improved.The legal responsibilities should be specified and the punishment on the violators should be more severe.Secondly,the government should strengthen the law enforcement,and establish the credibility system and regulation for claim.Thirdly,the pharmaceutical enterprises should be self-disci?plined,and improve their professional credibility.Fourthly,the governmental departments of business administration should take a strict control on awarding advertisement license to the media.Last but not the least,the consumers should improve their common medical knowledge.

BACKGROUND:Prosthesis friction interface is a hot focus in the study of total hip joint. Polyethylene wear particles induced inflammatory reaction, resulting in osteolysis surrounding the prosthesis and prosthesis loosening. To reduce polyethylene wear, ceramics-ceramics and ceramices-polyethylene friction interfaces were selected. High cross-linked polyethylene material with high intensity was selected. In young patients with large activity amount, the application of ceramic head is a great progress. OBJECTIVE:To assess the safety of large-diameter alumina ceramic matrix composites (BIOLOX? delta) bal on third-generation highly cross-linked polyethylene (Trident X3, Stryker, Mahwah, NJ) total hip arthroplasty in young patients, and to perform radiological measurements of high cross-linked polyethylene wear rate in the shortest two years after fol ow-up. METHODS:From July 2008 to June 2010, wear analysis of 30 cases aged less than 60 years with 32 hips with 36-mm BIOLOX ? delta ceramic femoral heads (CeramTec, Plochingen, Germany) on highly cross-linked polyethylene was performed in the 455 Hospital of Chinese PLA using Roman software (Robert Jones&Agnes Hunt Orthopaedic Hospital, Oswestry, United Kingdom). The mean age of patients was 56.8 ± 6.5 years. RESULTS AND CONCLUSION:Fol ow-up was conducted from 2 to 3.7 years old. There were no imaging evidences, such as dislocation, the bal head fracture or joint loosening or osteolysis. Mean Harris score was increased from (19.9±7.3) (11-36) before replacement to (35.3±5.4) at 6 months after replacement. The mean wear rate was (0.022±0.11) mm/year after run-in period. These data indicated that large-diameter ceramic head articulation against highly cross-linked polyethylene in young patients would have high safety for joint dislocation, prosthesis fragmentation and low wear rates.

BACKGROUND:Col um Femoris Preserving prosthesis is developed by Pipino, an Italian surgeon, and LINK (Germany). Whether the femoral osteotomy plane recommended in the surgical manual is suitable for Chinese people and whether the osteotomy method can cause stress changes of the prosthesis and femur has not been yet reported.
OBJECTIVE:Based on clinical reviews and three-dimensional finite element model, to analyze the clinical efficacy of total hip arthroplasty with Col um Femoris Preserving prosthesis and relevant stress distribution.
METHODS:We retrospectively analyzed 36 patients undergoing total hip arthroplasty with neck-retaining femoral prosthesis and 36 patients receiving total hip arthroplasty with biotype prosthesis in terms of Harris scores, visual analog scale scores, preoperative and postoperative measurements of eccentricity changes, IDES-Engh radiological evaluation and the incidence of complications. Two different osteotomy plane finite element analysis models were created to analyze the eccentricity difference and changes in the stress distribution of prosthesis and femur when the osteotomy plane was set 1.5 cm above the intertrochanteric fossa or at the junction of femoral head and neck.
RESULTS AND CONCLUSION:Neck-retaining total hip arthroplasty with the osteotomy plane set at the junction between the head and neck achieved good short-term outcomes, showing no difference from total hip arthroplasty with normal biological prosthesis. The finite element analysis showed that the eccentricity increased and the stress on the prosthesis and femur also increased when the osteotomy plane was set at the junction of femoral head and neck compared with that set 1.5 cm above the intertrochanteric fossa. But there was no difference in stress distribution between two osteotomy planes.

BACKGROUND:ETS-1,the first subgroup in the ETS family transcription factor,plays a key role in angiogenesis.Recent studies demonstrate that ETS-1 also has the important regulative functions in apoptosis of vascular endothelial cells.When the blood vessel begins to form,ETS-1 decides the apoptosis of partial endothelial cells.OBJECTIVE:To summarize the function and the research progress of vascular growth factor ETS-1 in angiogenesis and apoptosis.RETRIEVAL STRATEGY:A computer-based search in Pubmed,Sciencedirect and Ovid database was underwent to identify the articles from January 1990 to September 2007,with the Key word "ETS-1,angiogenesis,apoptosis,osteoblast,osteoclast" in English.Simultaneously,Chinese Journal Full-text Database and Wanfang database were retrieved for the related articles from January 2000 to June 2007,with the key word "ETS-1,angiogenesis,apoptosis,endothelial cell" in Chinese.Altogether 128 articles were collected and carried on the first examination.Inclusive criteria:①The articles closely correlated with ETS-1 in angiogenesis and apoptosis.②The articles published recently or in the authoritative magazine were chose for the identical domain.Exclusive criteria:Duplicated researches.LITERATURE EVALUATION:The articles were mainly the experimental study of EST-1 in angiogenesis and apoptosis.Among 31 selected articles,2 were reviews while other 29 for clinical or basic experimental studies.DATA SYNTHESIS:①When orthodontic tooth moves,alveolar bone rebuilding is the dynamical equilibrium process between bone absorption and new bone formation.This process mechanism is complex and adjusted by many kinds of factors.②Among numerous regulatory factors,ETS-1 is the dominant factor and has important effect on angiogenesis.③The research indicates,four kinds of typical vascular growth factors(acid fibroblast growth factor,basic fibroblast growth factor,vascular endothelial growth factor and epidermal growth factor) can induce the ETS-1 expression,and ETS-1 promotes vessel production through inducing the expressions of the related factors with angiogenesis,such as matrix metalloproteinase and integrin ?3.④Many progresses have been achieved in the regulatory effect of ETS-1 in angiogenesis,but it still has many problems,such as how the ETS-1 precisely regulate angiogenesis,how the ETS-1 precisely adjust apoptosis in gene expression and so on.CONCLUSION:As a kind of important regulatory factors,ETS-1 has important regulatory effects on angiogenesis and apoptosis.