For medical insurance systems, medical expense examination is a key measure to keep medical expenses under control. In 1948, Japan established an examination authority of legal person status to operate the medical expense examination. Based on years of modifications and improvement in the organizational system and operation mechanism, the system is running smoothly by now. Authors of this paper made a detailed introduction to the specific operations of such a system, and to China's local features as well. On such basis, the study proposed to build in China a third-party medical expense examination institution as a legal entity, and practice the reexamination system and information disclosure system, in an effort to safeguard legitimate rights of insurance organizations and medical institutions.

The Medical Care Act of Japan has undergone five major revisions since it went into effect in 1947. Each revision has been designed to target and tackle main problems found in the medical and health sector in the country. These problems range from the making of regional healthcare plans to the establishment of the hospital with specific functions, from the division of rehabilitation beds to the establishment of nursing insurance scheme, from the birth of medical corporations to the establishment of social medical corporations, and from strengthening of non-profit nature of medical institutions to the construction of medical information system. These efforts were made to provide a safe and convenient health service for the Japanese people. These revisions are closely related to hospital management, and its experiences prove useful for the health reform in China.

The clinician training system in Japan is different from that in China as their medical students are allowed to take medical doctor examination immediately following their graduation.But they must undergo at least two years of training in basic clinical knowledge and skills prior to taking any clinical practice.This training system is inspirational for us as follows:China should include standardized training of residents into the law of medical practitioners,and medical graduates must take two years of knowledge training in full medicine before they are qualified for clinical practice.On top of this training,they need to undergo at least three years of specialized doctor training,making them competent clinicians with comprehensive knowledge coverage and outstanding skills in specific areas following such staged training.

Conventional chemotherapy drugs, molecularly targeted drugs, and immune checkpoint inhibitors are the major constituents of anti-tumor drugs in clinical settings at present. Molecularly targeted drugs specifically target the key proteins, genes, or signal transduction pathways in tumor cells which are essential for initiation and development of tumor, resulting in selective activity to induce cell death or growth inhibition. Molecularly targeted drugs have emerged as the mainstream in the research and development of anti-tumor drugs due to its high selectivity and low toxicity. Natural products refer to the chemical constituents or metabolites originated animals, plants, or microorganisms, which have been recognized as one of the important sources of drug discovery with abundant resources and diversified structures. At present, a number of molecularly targeted anti-tumor drugs derived from natural products or their derivatives have been approved for cancer therapy or in clinical trials. This review will summarize the molecularly targeted anti-tumor drugs derived from natural products or their derivatives according to their different cellular targets, and also outline the molecular mechanism, progress, and perspectives of these drugs.

OBJECTIVE:To study the bioequivalence between cefadroxil capsules and its reference capsules and pharmacokinetics in 22 male healthy volunteers METHODS:A dose of 1 000mg cefadroxil(test and reference products)was given according to a randomized cross-over design Plasma concentrations of cefadroxil and internal standard(amoxicillin) were determined by HPLC RESULTS:The concentration-time curves of both preparations fitted to a one-compartment model The main parameters of test and reference products were as follows:T1/2ke were (1 40?0 15)h and (1 44?0 23)h;Tmax were (2 3?0 5)h and (2 2?0 3)h;peak concentrations(Cmax) were (30 59?4 25)?g/ml and(30 57?4 24)?g/ml,AUC were(99 31?14 50)?g/(ml?h) and (99 22?15 11)?g/(ml?h)respectively CONCLUSION:Relative bioavailability was(100 42?7 62)% The two formulations were bioequivalent

OBJECTIVE:To evaluate the pharmacoeconomic(PE) efficacies of three therapeutic schemes in the treatment of community acquired pneumonia.METHODS:By applying the principle of decision tree analysis in pharmacoeconomics,a retrospective analysis and evaluation was performed on the following 3 therapeutic schemes:sequential therapy of levofloxacin hydrochloride injection,cefuroxime sodium for injection by iv gtt,and azithromycin for injection by iv gtt.RESULTS:The total costs of the three schemes were 4 327.56 yuan,5 327.32 yuan,and 5 074.14 yuan,respectively,and the total effective rates were 89.80%,88.80%,and 85.29%,respectively.The anticipant costs for each cured case of community acquired pneumonia were 3 886.15yuan,4 730.66yuan,and 4 327.73yuan,respectively.CONCLUSION:The sequential therapy of levofloxacin hydrochloride injection is the optimal one among the 3 schemes.

Although globally recommended standardized stratification treatment of acute myeloid leukemia (AML) effectively improves its therapeutic effects and prognosis,due to unknown personalized differences of tumorous biology,most of the patients eventually develop to therapy failure,relapse,and even death.Additionally,a number of patients are naturally resistant to current used combined chemotherapy and with extremely poor prognosis,This review presents definitions of refractory and relapsed AML,then describes their pathogenetic mechanism and lastly summarizes three aspects of therapeutic principle,clinical drugs and hematopoietic stem cell transplantation (HSCT).To review advances in relapsed and refractory AML diagnosis and treatment will be helpful to master disease characteristics and to guide clinical treatment.

The truncated binary exponential back-off algorithm is one of the most effective methods applied in collision resolution process of random multi-access channel. In this study, two new strategies are presented to improve the capability of the truncated binary exponential back-off algorithm. In the new strategies, the sizes of the initial window size or the operating window sizes are adjusted dynamically, which always bring a significant improvement for the self-adaptability of the original algorithm. A series of experiments are simulated and the results verify that the new strategies can make the implementation more stable and effective than the original algorithm.

Acute myeloid leukemia (AML) is a group of heterogeneous diseases with diverse genetic abnormalities,variable responsiveness to therapy and prognosis.In recent years,a lot of information has become available regarding chromosome and gene mutations that occur in AML and their influence on prognosis.Improvements in the understanding of molecular biology of AML are critical for accurate diagnosis.risk stratification,monitoring of minimal residual disease and provides opportunities to develop targeted therapies and improve the clinical outcome.This article reviewed chromosome abnormalities and characteristic gene mutations,and discussed their clinical signiflcances and presented new drugs in clinical trials presented in the 55th ASH annual meeting.

Objective To explore the clinical and MR imaging features of myxoid liposarcoma.Methods Clinical and MR imaging data of 7 patients with histologically confirmed myxoid liposarcomas on extremities were retrospectively analyzed.The age of the patients ranged from 41 to 59 years with a median age of 51 years.Results Three tumors occurred in thigh,two in calf,one in foot and one in shoulder.Six tumors were situated deeply,and one was superficial.On T_1-weighted images,all 7 tumors showed predominant isointense or slightly hypointense signals relative to muscle,with 6 having lacy,linear or amorphous loci of high signal intensity.The major portion of each tumor displayed hyperintense signals compared with fat on T_2-weighted images.Following the injection of Gd-DTPA,all tumors showed inhomogenous and strong enhancement.All tumors had septa and were well defined without obvious surrounding edema and invasion of the adjacent bones.Conclusion Myxoid liposarcomas usually show predominant isointense or slightly hypointense signals relative to muscle on T_1-weighted images and hyperintense signals relative to fat on T_2-weighted images.The fat components within the tumors may be identified as linear,lacy or amorphous foci of high signal intensity on T_1-weighted images.The contrast enhancement of the mvxoid liposarcomas is usually pronounced and heterogeneous.