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. 

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

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 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.

[Objective]To evaluate the therapeutic effect of treating AO type C fracture of the distal radius with open reduction LCP plate internal fixation.[Method]From Jan.2004 to Jan.2007,37 cases of AO type C fractures of the distal radius were treated with LCP plate internal fixation.All cases were fixated through volar approach,the length of radius,waist joint angle were recovered,screwed the plate,the exposure of dorsal soft tissues could be obtained by internal-rotate radius,allo-bone graft,and aoto-bone graft was necessary for the case with bone defect.Passive wrist motion,active finger motion and forearm rotation were encouraged immediately after surgery.Active wrist motion was suggested seven days postoperatively.[Result]The 37 cases were followed up for 8 to 21 months,with an average time of 11 months.X-ray pictures showed that one-stage union was achieved in the patients,with a mean healing time of eight weeks.No such complications were found as infection,non-union,loosing of nails,carpal tunnel syndrome or medium neuritis.Their clinical outcomes were evaluated according to modified McBride grading system.Twenty-five were rated as being excellent,eight as good and four as fair,with their good-excellent rate as being 89.18%.[Conclusion]Treatment of type C distal radius fracture with LCP plate internal fixation has many advantages,such satisfactory reduction,rigid fixation,and excellent function.

Objective To evaluate evidence-based practice of catheter removal strategy in patients with short-term indwelling catheter after partial nephrectomy. Try to apply the best evidence into practice, and further to improvethe quality of clinical nursing through quality review. Methods Two rounds of quality review were carried out in the 2 wards from July to December in 2016. Using the 5 review criteria of best evidence, we reviewed baseline of catheter removal strategies for patients with short-term indwelling catheter after partial nephrectomy and developed appropriate evidence-based practice. Further, the best evidence was integrated into clinical nursing practice, and the prognosis was reviewed after then. Results In the baseline review, the compliance of the 5 review criteria was 0. However, after introducing the best evidence into nursing practice,the compliance was up to 100%. The mastering of evaluation knowledge of catheter removal of nurses increased from 73.00 ± 9.35 to 94.81 ± 3.38 with significant difference (t=12.72, P<0.01). The indwelling time of catheter shorted from (5.69±0.79) d to(4.24±0.82) d. The difference was significant (t=5.47, P<0.01). Conclusions Evidence-based nursing practice improvesthe strategies of short-term catheter removal after partialnephrectomy, while closer cooperation between nurses and doctors are still needed to promote the continuous improvement of nursing quality.

Objective To investigate the clinical results and prognosis between proximal and total gastrectomy in proximal advanced gastric cancer.Methods The clinicopathological data of 221 patients with proximal advanced gastric cancer who undcrwent radical gastrectomy were retrospectively analyzed.82 patients and 139 patients underwent proximal and total gastrectomy respectively.The number of dessected lymph nodes,postoperative complications and mortality were compared.Kaplan-Meier survival rate curves and Log-rank test were drawn and compared.Results A total of 1 411 (11-34) and 3 345 (14-35) lymph nodes were harvested from the surgical specimens of 82 and 139 patients with proximal and total gastrectomy respectively,the average number of harvested lymph nodes was 17 ± 11 and 24 ± 10 (t =2.586,P ＜0.05).The overall complications in proximal gastrectomy were higher than total gastrectomy (73.2％ vs.30.2％,x2 =38.291,P ＜0.01).The ratio of functional delayed gastric emptying,anastomotic leakage and stenosis,reflux esophagitis in proximal gastrectomy patients was higher than total gastrectomy.The survival rate in proximal gastrectomy were lower than total gastrectomy in proximal advanced gastric cancer (P ＜0.01).Conclusion Total gastrectomy is recommended for proximal advanced gastric cancer.

16 standered acrylic resin blocks with silicone resilient denture liner(10 mm ×8 mm ×3 mm)incorporated with nano-silver par-ticles at 5% (m/m,by dry wet)in-between were prepared.8 blocks were immersed in distilled water for 24 h at 37 ℃ as the controls (group 1).Another 8 were thermocycled for 4 000 cycles(group 2).16 acrylic resin bars were thermal cycled for 4 000 cycles.Then they were processed exactly as the control group (group 3).Tensile bond strength of the specimens was measured by a universal testing machine. The bond strength values(MPa)of group 1,2 and 3 were 2.683 ±0.435,2.179 ±0.633 and 1.460 ±0.566 respectively(group 1 vs 2,P>0.05;group 3 vs 1 or 2,P<0.05).The failure mode of the blocks in group 1 and 2 was mainly cohesive failure,in group 3 adhesion fail-ure.