Based on the related theories of physician behavior analysis, summarize and discuss the incentives mechanism of supplier payment on physician behavior and its inner mechanism, provide theoretical supports and political suggestions for further analysis on payment reform.

BACKGROUND:Nano bone putty and bone cement injection are two common methods to strengthen the fixation of pedicle screws, but there are relatively few reports on the comparison of their strengthening effects. OBJECTIVE:To compare the biomechanical characteristics of bone cement and nano bone putty strengthening pedicle screw implantation in the fixation of osteoporotic vertebral body. METHODS: Totaly 24 human cadaveric pedicles were obtained, which were al in line with osteoporosis standards, and randomly divided into 3 groups: control group (only implanted pedicle screws), bone cement group (first injected bone cement in the nail channel, and then implanted pedicle screws) and nano bone putty group (first injected nano bone putty in the nail channel, and then implanted pedicle screws). After 2 hours of implantation, the maximum axial pulout strength and the maximum rotation torque of specimens in each group were determined. RESULTS AND CONCLUSION:The maximum axial pulout strength and maximum rotation torque of the bone cement and the nano bone putty groups were greater than those of the control group (P < 0.05), and the maximum axial pulout strength and the maximum rotation torque of the bone cement group were greater than those of the nano bone putty group (P < 0.05). These results demonstrate that the maximum axial pulout strength and the maximum rotation torque of pedicle screw implantation in the fixation of osteoporotic vertebral body can be effectively improved by injection of bone cement and nano bone putty, and the strengthening effect of bone cement is more obvious. 

Electrophysiological studies have shown that the spinosolitary tract-dorsal column postsynaptic (SST-DCPS) neurons may project to both the dorsal column and solitary tract nuclei. In order to demonstrate the neurons morphologically, fluorescein dyes, PI and Bb, were injected into the dorsal column nuclei and the solitary tract nucleus respectively. A total 282 cells were found to be retrogradely labeled in the spinal dorsal horn in 10 adult rats. Of them, 51 (18%) cells were PI-Bb doubly labeled; 120 (43%) were PI labled alone; and 111 (39%) were Bb singly labled. Most of these double-labled cells were concentrated in laminae III-V. The existence of double projection neurons that project to both the dorsal column and solitary tract nuclei, namely the physiologically identified SST-DCPS neurons, is morphologically confirmed in the present study. These neurons may transmit information to both visceral and somatic sensory nuclei, indicating they may play an important role in the convergence of somato-visceral afferents.

OBJECTIVE:To study the anti-inflammatory effect of ethanol extract of Polygonum multiflorum METHODS:To observe the oedema severity and vaso-permeability in inflamed animal and the response of animal to pain induced by acetate acid after the ethanol extract of Polygonum multiflorum had been intragastrically given for 3 days RESULTS:The oedema severity and vaso-permeability were obviously decreased by the ethanol extract of Polygonum multiflorum and this effect could last 4 hours At the large dose,analgesic effect was observed CONCLUSION:The ethanol extract of Polygonum multiflorum exhibits intensive anti-inflammation effect and the mechanism may be related to its immuno-depression effect

Objective:To explore the effect of infection on autophagy-related proteins,Beclin-1 and LC3,expression in cerebral white matter in newborn rats.Methods: A total of 64 two-day-old Sprague-Dawley(SD) rats were randomly divided into control and experimental groups(n=32 each).At day 2 to 6 after birth,the rats in experimental group were intraperitoneally injected with 0.6 mg/kg of lipopolysaccharide(LPS) once a day to establish a white matter injury induced by infection in neonatal rats while the rats in control group were injected with equal amounts of normal saline.Rats were sacrificed to collect brain tissues at 12 hour,1,3,5 d after model establishment.HE staining was performed to observe the pathological changes.Changes in the expression of Beclin-1 and LC3 in rat white matter were examined by Western blot and RT-PCR.Results: Growth and development of rat in experimental group was slow,cerebral white matter lesions were obvious.Compared with the control group,the experimental group Beclin1 and LC3 protein and mRNA levels in the model after 12 h began to express,1 d reached the peak,and then decreased,each time points were higher than the control group(P<0.05).Conclusion: Early infection in neonatal rats can cause white matter damage;the expression of autophagy-related proteins,Beclin1 and LC3,showed that autophagy may be involved in the pathological process of white matter damage induced by infection.

BACKGROUND: In order to enhance the rate and degree of osseointegration of cementless implants, hydroxyapatile(HA) was applied on the different prosthesissurfaces. Themajoritiesofthesestudieshaveutilized non-weight-bearing in vivo dog models and have focused on the fixation of the femoral component. What is the osseointegration of macrotextured acetabular components in a weight-bearing model(dog) like?OBJECTIVE:To evaluate the various macrotextured surface coatings applied to acetabular components of the same design in aweight-bearing canine total hip replacement model.DESIGN: Randomized conparative study using theexperimentalanimals as subjectsSETTING: Department of Ortopaedics, Beijing Tongren Hospital;PathologyDepartment, Bone and Joint Laboratory,St. Michael' s Hospital, U of T,Toronto,CanadaMATERIALS: The experiment was completed in the Pathology Department,Bone and Joint laboratory, St. Michael' s Hospital, U of T, Toronto, Canada from October 2001 to December 2001. Acetabular components with the selected surface characteristics were implanted into forty dogs with the body mass of 29 - 44 kg of either gender and divided into seven groups, including group 1 (AD/HA), Group 2 (CoCr beads/PA), Group 3 (CPTi bead surface),Group 4(CPTi 30 PPI foam),Group 5(CPTi 30 PPI/PA foam),Group 6(CPTi 40 PPI foam), Group 7(CPTi 40 PPI/PA foam).METHODS: Exercise was restricted to leash walks for the first fourteen days post-operatively. After this, dogs were allowed unrestricted activity. The dogs were euthanized at either three or sixmonths after surgery as the project' s protocol. The whole acetabulum,divided into weight-bearing and non weightbearing areas, containing the component was harvested and submitted for histological and histomorphological assessment. MAIN OUTCOME MEASURES:The bone ongrowth and ingrowth with weight bearing and without weight bearing areas in each group.RESULTS:There was significantly greater bone apposition and bone ingrowth for implants withHAcoatingsascompared to uncoated implants. There was also significantly greater bone ingrowth in weight-bearing areas as compared tonon weight-bearing areas at both time periods. The bone growth into AD/HA was 17％ at 3 months and descended to 14％ at 6 months. The bone growth into CPTi beads surface was 21％ at 3 months,30％ at 6months in weight-bearing areas. All four foam-coating surfaces there were 15％ to 21％ ongrowth at 3 months,15％ to 32％ at 6 months and 21％to 32％ingrowth at 3 months,29％to 45％at 6 months in weight-bearing areas( P ＜ 0.05).CONCLUSION: Hydroxyapatite coating produces significantly greater boneingrowth andappositionin all thesurfacetreatmentstestedinthis study. Weightbearingproducesagreater boneingrowththannon weight-bearing areas and obviously increases with the time prolonging, especially the foam coating

Objective To establish the 3rd national standard for un-fractionated heparin for National Institutes for Food and Drug Control(NIFDC).MethodsFour candidate heparin samples(code ampoule 1,2,3,4)were assayed against the International Standard(07/328)and National Standard(150509-200912).Jiangsu Institute for Food and Drug Control(JSIFDC)determined the potency of anti-FXa and anti-FIIa by chromogenic substrate methods and the potency of anticoagulation by whole rabbit blood of Chinese Pharmacopoeia(2015).Results All of the data from our institute were adopted to calculate the 3rd national standard for un-fractionated Heparin.NIFDC analyzed the data from 13 laboratories.The geometric coefficient of variation of inter-laboratory and intra-laboratory were both below 10％.Conclusion Approved by the national drug standards material Committee,the candidate(140817-201501)was recommended to be the 3rd national standard for un-fractionated Heparin with an assigned value of 2011IU per ampoule.

Platelet-rich plasma is a volume of autogenous plasma with a high platelet concentration. Platelet-rich gel which is polymerized from platelet-rich plasma becomes a hot topic in the repairing of jaw bones in oral and dentofacial surgery. Presently, the mechanism of platelet-rich gel in enhancement of bone defect repair has not been clarified. Generally, we believed that the unifiation of blood platelet degranulation released many high-concentration growth factor during polymerization stimulated bone formation and accelerated bone repair. In addition, the application of platelet-rich gel has some problems. Thus, wide application of platelet-rich gel in tissue engineering deserves further studies. With the development, platelet-rich gel should be widely used in bone tissue engineering.

Objective To investigate the clinical effects of fluoxetine combined with small doses of aripiprazole in treatment of post -stroke depression and the influence on the recovery of neurological function. Methods 74 patients with post stroke depression were randomly divided into the two groups,all patients were given routine comprehensive treatment,the control group treated with fluoxetine,while the observation group was treated with fluoxetine combined with small doses of aripiprazole,clinical curative effect,neurological deficits and activities of daily living of the two groups were compared.Results The total effective rate of the observation group was 94.59%,which was significantly higher than 78.38% of the control group (χ2 =9.78,P<0.05);NIHSS scores of the observation group at the end of 4 week and 8 week of treatment were (10.85 ±1.22)and (6.03 ±0.78),which significantly reduced than that of the control group(t=6.18,6.62,all P<0.05 );Barthel index of the observation at the end of 4 weeks and 8 weeks of treatment were (49.56 ±4.68)and (67.43 ±4.75),which significantly increased than that of the control group(t=6.63,7.00,all P<0.05);The incidence of adverse reactions of the two groups had no signif-icantly different(χ2 =2.38,P>0.05).Conclusion Fluoxetine combined with small dose of aripiprazole has an ex-act effect in the treatment of post stroke depression,with high security.