Objective:To evaluate the levels of interleukin 18(IL-18) mRNA in peripheral blood mononuclear cells(PBMCs),livers and spleens in monkey endotoxic shock models.Methods:Cynomolgus monkeys were injected i.v. with lipopolysaccharide(LPS) (2.8 mg/kg) to prepare the endotoxic shock models. The mRNA levels of IL-18 in PBMCs,livers and spleens were tested by fluorescence semi-quantitative realtime reverse transcription(RT)-PCR and compared with that of TNF-? and IL-1?.Results:IL-18 mRNA expression in PBMCs remarkably increased at 120 min after LPS administration, so did in livers and in spleens at the same time. mRNA levels of TNF-? in PBMCs peaked at 60 min after LPS injection, and also increased markedly at 120 min in livers and spleens. IL-1? mRNA levels peaked at 60 min in PBMCs, and did not change so much in livers and in spleens.Conclusion:IL-18 mRNA expression in PBMCs can be up-regulated by LPS, but changed latterly than TNF-? and IL-1? in endotoxic shock cynomolgus monkeys. It is presumed that IL-18 can be produced by PBMCs and liver Kupffer cells(maybe splenic macrophages),and TNF-? is produced by a variety of cells, but IL-1? in bloodstream mainly come from PBMCs after LPS challenge.

Objective To study the outcomes and problems of comprehensive medical pricing reform in Jiangsu.Methods The business operations,drug proportion and patient′s expenses of 28 pilot hospitals in 1 5 counties of the province before and after the reform were compared,to learn the impacts of the pricing reform on both hospitals and patients.Results Medical revenue and medical service quantity of these hospitals during this period(January to June)of 2012—2014 maintain a fast growth,with lower drug proportions,and patients′expenditure unchanged.Compared with data of the same period in 2012, the total revenue growth rates of the hospitals in 2013 and 2014 were 13.4% and 1 1.1% respectively;and their drug proportions were 44.9% and 42.3%;and the expenditure growth rates for outpatient/emergency service were 5.9% and 3.1% respectively.Conclusions The reform has achieved an initial success.However the pricing system,needs to be further rationalized to build a better price formation mechanism,in line with relevant reforms.

Objective To investigate the value of serological screening combined with fetal aneuploidy prenatal noninvasive DNA test ( NIPT) in prenatal diagnosis ,and provide guidance for reducing the birth of children with genetic defects in the future .Methods A retrospective analysis was conducted in 15282 pregnant women with prenatal counseling who performed serological screening and NIPT test .The high risk and critical TANG recommended NIPT test and severe abnormal karyotype children recommend termination of pregnancy .Results Down syndrome screening results showed that 804 cases of 15,282 cases of serological screening samples were detected in high risk , the high risk rate was 5.26％.A total of 804 patients with high risk of Don screen were further tested with noninvasive DNA,which was positive in 10 cases.Among them,8 cases were confirmed by amniocentesis ,including 5 cases of trisomy 21,1 case of trisomy 18 and 2 cases of sex chromosome abnormality (45,XO in one case and 47,XYY in one case),the consistency was 100.00％.Conclusion Noninvasive gene detection of fetal aneuploidy has the advantages of noninvasive ,safe and accurate .It has a wide range of clinical value in the diagnosis of fetal chromosomal abnormalities .