It is a well-recognized difficult empirical task to disentangle the moral hazard effect from adverse selection impact by using the health insurance data in the empirical research of health economics. In the research, the unique social experiment in China’s health care reform, which enables cleanly identify moral hazard is applied. Using individual-level hospital patient data, it estimates the impact of the reimbursement rate increase on Chinese patients’ demand for health care service. Difference-in-Difference Propensity Score Matching approach and find strong evidence for moral hazard are approached. For instance: if the reimbursement rate increases by 5% while other factors remain the same, the corresponding health care service expenditure will increase by around 7%. The finding also has important implication for policy making. Chinese government pledges to lower the average individual out-of-pocket cost from the current 37.5% of total health care service cost to 30 % in 5 years. According to the former estimation, if the goal of the policy is successfully achieved, moral hazard problem itself will cost Chinese health care system around 200 billion yuan.

Objective　To study the effect of rehabilitation training on the expression of Fos in the central nervous system(CNS) of rats with cerebral infarction. Methods　60 SD rats were made as cerebral infarction models and divided into 2 groups at random 24 hours later: rehabilitation group was given balancing, grasping, rotating and walking and other trainings everyday, while immobiligation group was fixed in cages. Immunohistochemistry was used to detect the Fos expression 1 d, 7 d, 14 d, 21 d and 28 d after infarction respectively. Results　Fos-positive immune reaction appeared in cortex,thalamus, hypothalamus, reticular form and posterior gray horn of the spinal cord of both groups　.Rehabilitation group responded stronger than the immobilization group significantly (P<0.01).Conclusion　Rehabilitation training can activate cortical neurons around the infarted focus and in its opposite side of the CNS, and thus promote the recovery of rats' motor functions.

Objective To work out a flowchart for putting normal saline column by gravity drip via Groshong PICCs to guide intracavitary ECG and investigate the effect. Methods We developed the flowchart and trained the nurses to use it. Then the flowchart was used in catheteration of Groshong PICC to guide intracavitary ECG for 30 patients. Results The normal target rate was 93.3%(28/30) and the optimal tip target rate was 90.0%(27/30). The score on the flowchart by the nurses was (4.8 ± 0.4), indicating they were satisfied with it. Conclusion The flowchart for pushing normal saline column with gravity drip method via Groshong PICCs to guide intracavitary ECG provides an operational standard, enhancing the operational quality.

[Abstract ]Objective:To estimate dental maturation norms of permanent dentition in a group of Nanjing children using Nolla's tech-nique.Methods:549 cases of panoramic radiographs (279 males and 270 females)of Nanjing children at the age range of 3 to 16 years were collected for the study.All permanent mandibular teeth on the left side (except for the third molars)were scored according to Nolla's method,and data were presented in tables and used to plot dental maturation curves for the Nanjing boys and girls.Results:Females were found to be more advanced in the degrees of dental development.Dental maturation is significantly associated with chron-ological age (for males and females:r =0.959,P <0.001 and r =0.953,P <0.001,respectively).The mathematical model of them was established,and then the fitting equation was obtained.Conclusion:The dental maturation curve and chronology of permanent dentition can provide the growth norms of permanent teeth for Nanjing children and facilitate the way for dentists to assess the growing children during diagnosis and treatment planning.

It is always an important academic and policy issue to understand the impact of hospital distance on Chinese inpatient service demand in rural areas. It employs household survey data collected from 97 villages in Shandong in 2006 and 2008, and investigates the influences of hospital distance on the demand of famars in rural areas. The discrete choice model is constructed to estimate the inpatient service demand function for patients in rural areas. The empirical analysis finds that the hospital distance is significantly affecting Chinese inpatient service demand in the rural areas. The longer the distance increases, the lower the visiting rate drops. In addition, the impact changes with the changes of hospital level; the lower the primary hospital is, the higher the impact would be. It paper provides new evidence for the understanding of the geographical characteristics of medical health care.

Objective To explore the ultrasonographic, clinical and histopathological characteristics features of primary uterus lymphoma. Methods The clinical, sonographic and histopathological characteristics of nine patients who were pathologically comfirmed as primary uterus lymphoma were analyzed. Results Among the nine cases of primary uterus lymphoma, three lesions were found in the uterine bodys and 6 were found in the cervixes. Two patients with uterine body lymphoma had painless pelvic masses and six patients with cervix lymphoma had contact bleeding, including irregular vaginal bleeding in four patients. In sonograms, six lesions showed remarkable hypoechogenicity with homogeneous internal echogenicity;the margins of most lesions were circumcribed;all lesions had posterior enhancement. In color Doppler lfow imaging, abundant vascularities were detected in eight lesions. In the cases of uterine body lymphoma, all of the uterine bodys showed diffuse symmetrical enlargement without disruption of the endometria, while in ifve cases of cervix lymphoma, the tumors showed the shape of lobule. The pathological examination showed that all tumors were diffuse B-cell type non-Hodgkin lymphoma. Conclusions Primary uterus lymphoma has some clinical and ultrasonic features, including contact bleeding or irrgular vaginal bleeding, diffuse symmetrical enlargement of uterine body, complete endometria, remarkable hypoechogenicity, homogeneous echogenicity and posterior enhancement. Final diagnosis depends on the histopathology.

Objective To investigate the changes of expressions of axon guidance molecule Sema3F and its receptor Np2 in hippocampus of temporal lobe epilepsy(TLE)rat.Methods Rats were injected with Lithium-chloride,Pilocarpine intraperitoneally to establish TLE model.The Sema3F mRNA,Np2 mRNA and protein in areas CA1,CA3 and dentate gyrus(DG)of hippocampus at different time were detected by immunohistochemistry and in situ hybridization for TLE models.Further,they were compared with normal control group.Results Compared with normal control group,the expressions of Sema3F mRNA,Np2 mRNA and protein in areas CA1,CA3 significantly decreased(P

Objective To study the effect of rehabil it ation training on the expression of S-100, GFAP and Nestin in the cortex of cer ebrally infarcted rats. Methods Sixty Sprague-Dawle y rats were used. Experimental cerebral infarction was caused in all the rat s. 24 hours after the infarction, all the rats were randomly divided into 3 grou ps: a rehabilitation group, an immobiliaztion group and a control group. The rat s in the rehabilitation group were given balancing, grasping, rotating and walki ng exercises everyday, while those in the immobilization group were immobilized in cages. The rats in the control group was without any treatment. Immunohistoc hemical technique was used to detect the S-100, GFAP and Nestin expression at t he time points of 24 hours, 1, 2, 3 and 4 weeks after infarction, respectively. Results S-100, GFAP and Nestin expression were foun d around the infarcted cortex. The response increased as the extension of the su rviving time. The immunohistochemical reaction in rats in the rehabilitation gro up was stronger than that in the immobilization group. Conclusi on Rehabilitation training can activate astrocytes, which could impr ove the internal environment, protect the neurons and promote repairing of neuro n.

Objective:To identify the effect of ?-synuclein overexpression on mitochondrial membrane structure with atomic force microscopy. Methods:?-syn expression was mediated by AAV (adeno-associated viral vector) and Recombinant AAV/?-syn and AAV/LacZ viral particles were stereotaxically injected in the left side of rat substantia nigra (SN) for rat model of ?-synuclein overexpression. Mitochondria were isolated from rats SN of Brain. Mitochondria were analysis with JC-1 staining,atomic force microscopy and Western blot. Results:By 16 weeks post-infection of AAV-?-syn,the level of ?-syn increased about 2 times in mitochondrial fraction with Western blot and mitochondrial membrane potential (??) decreased with JC-1 staining. Furthermore,mitochondria swelling and porous like structure formed on the mitochondrial membrane with atomic force microscopy. Conclusion:The data suggested that ?-syn could accumulate in mitochondria,might form mitochondrial membrane pores and lead to ?? decreases. ?-syn might lead to mitochondrial dysfunction in Parkinson's disease.

Objective To evaluate the association of serum uric acid and the incidence and prognosis of kidney diseases systematically, so as to provide reference for the treatment and prevention of kidney diseases. Methods Literatures related to the associations between serum uric acid and incidence and prognosis of kidney diseases were selected from the Chinese Biomedical Literature Database ( CBM) (January 1982 to March 2010), EMBASE (January 1966 to March 2010) and Medline (January 1950 to March 2010) for cohort studies. Two researchers independently screened the studies, assessed the risk of bias of included studies using the Newcastle-Ottawa Quality Assessment Scale for Cohort Studies and extracted data. Stata 10. 0 was used to calculate the pooled relative risk. Results Twenty-one eligible cohort studies were selected, of which 11 on incidence of kidney diseases (n =276 801 ) , and 10 on the prognosis of kidney diseases ( n = 3004). Meta analysis was performed based on data influencing incidence and prognosis factors of kidney diseases except for serum uric acid. The results showed, (1) uric acid and incidence of kidney diseases: hyperuricemia could increase the risk of kidney diseases ( RR = 1. 49, 95% CI 1. 27-1. 75) ; (2) uric acid and prognosis of patients with kidney diseases:hyperuricemia could deteriorate the kidney function (RR = 1. 35, 95%CI 1. 12-1.63) and increase the risk of mortality (RR = 1.67, 95% CI 1.29-2.16). Conclusion Uric acid is an independent risk factor for incidence of kidney diseases and poor prognosis of patients with kidney diseases. Further high quality clinical trials with long-term follow up should be conducted to determine whether lowering uric acid levels would be of clinical benefit in the prevention and treatment of kidney diseases, so as to provide direct evidence for clarifying correlation between uric acid and kidney diseases and the prevention and treatment for patients with high uric acid.