The drug zero-profit reform in place has changed the compensation channels for China's public hospitals at the county level.In view of this situation,the paper probed into the present landscape of the compensation mechanism at such hospitals.The authors analyzed five compensation channels,i.e.,the special government budget subsidy,adjustment of medical service charges and rates,health insurance payment,social financing,and income/expenditure management.The study aimed at providing policy proposals and references for sustainable reform at such hospitals.

Objective To investigate the distribution of neurons expressing Fos protein in central nervous system (CNS) following esophageal mucosal acid exposure,and to map the contribution of spe- cific brain areas in sensitizing responsivity and emphasize the coding change of CNS to the esophageal acid stimulation.Methods Thirty-six healthy Sprague-Dwley rats were randomly divided into five groups. Group A (n=6) was normal group of home cage control animals to which no stimulation was given. Group B (n=7) was saline group which received esophageal perfusion with normal saline solution (0.9% NaCl).Group C (n=8) was treated with esophageal mucosal acid exposure containing 0.1 mol/L HCl. Group D (n=7) was sensitized by ovalbumin.Group E (n=8) received basal ovalbumin-sensitization plus esophageal mucosal acid exposure.The rat model of esophageal visceral hypersensitivity was estab- lished by the basic ovalbumin-sensitization combined with intra-esophageal mucosal acid exposure.The neuronal expressions of c-fos proto-oncogene were detected with immunohistochemical counter-staining and computerized color image analyzer under various conditions.Results The rats in model group with basic ovalbumin-sensitization plus esophageal acid perfusion initiated a high density expression of c-fos- immunoreactive(Fos-IR) neurons in multineuronal networks.A significantly higher number of Fos positive neurons was found in the model group than those in the corresponding regions of other groups (P＜0.05) in the following brain areas:frontal and parietal cortex,insular cortex,cingulated cortex,central amyg- daloid nucleus,the K(?)lliker-Fuse nucleus,the nucleus ambiguus,parabrachial nucleus,hypothalamic paraventricular nucleus,paraventricular thalamic nucleus,paratrigeminal nucleus,the nucleus of solitary tract,area postrema,reticular nucleus of medulla,whereas no significant difference was found in the dorsal motor nucleus of the vagus,supraoptic nucleus,periaqueductal gray matter or orbital part of infe- rior frontal gyrus.The values of Fos-IR neurons were also increased in the central amygdala,parabrachi- al nucleus,paraventricular nucleus,the paratrigeminal nucleus and NTS in the model group than that in the corresponding regions of other groups (P＜0.05).Conclusion The basic ovalbumin-sensitization fa- cilitated dramatically the c-fos expression evoked by esophageal acid perfusion,suggesting that visceral hypersensitivity induced by ovalbumin may alter cortical reactivity processing of esophageal acid stimula- tion in brain areas.

AIM: To study the effect of breviscapine on the oxidative stress in the liver and kidney in diabetic rats. METHODS: Diabetes was induced by injection of streptozotocin (ST Z). Rats were randomly divided into three groups: control group, model group, mo del group treated with breviscapine. 8 weeks after STZ injection, liver lesion w as evaluated using HE, oil red O staining and kideny lesion using PAS staining. Malondiadehyde (MDA) levels and antioxidant activities in liver and kidney tissu e were determined by spectrophotometric method. RESULTS: Light microscopy in HE staining showed that liver fatty score was significantly lower in the breviscapine group compared with model ani mals (0.55?0.43 vs 1.54?0.65, P

OBJECTIVETo observe clinical efficacy of Huazhuo Jiedu Recipe (HJR) on chronic atrophic gastritic precancerosis (CAGP), and its effect on contents of lactic acid, total acid, free acid, and nitrite in the gastric juice, as well as tumor markers in gastric juice and blood.

METHODSTwo hundred and twenty-nine patients with CAGP were randomly assigned to two groups, the 119 patients in the treated group orally took HJR and the 110 patients in the control group orally took Weifuchun Tablet. The therapeutic course for all was three months, two courses in total. The therapeutic efficacy, changes of gastric acid contents before and after treatment were observed, and the tumor markers in the gastric juice and blood were detected using electrochemical luminescence immunoassay.

RESULTSThe pathological effective rate was 83.2% (99/119) in the treated group and 60.9% (67/110) in the control group, showing significant difference between the two groups (P <0.05). The total acids and free acids in the gastric juice were significantly improved, contents of lactic acid and nitrite were significantly lowered in the two groups. Both contents of carcinoembryonic antigen (CEA), carbohydrate antigen19-9 (CA19-9), carbohydrate antigen72-4 (CA72-4), and carbohydrate antigen125 (CA125) in the gastric juice and serum were significantly lowered after treatment in the treated group (P<0.05). Compared with the normal control group, the therapeutic effect was more obvious in the treated group (P<0.05).

CONCLUSIONSHJR could stimulate the gastric membranous secretion, enhance contents of total acids and free acids. It could prevent the further progress of CAGP by decreasing contents of lactic acid and nitrite in the gastric juice, and lowering contents of CEA, CA19-9, CA72-4, and CA125 in the gastric juice and serum.

Adult ; Aged ; Biomarkers, Tumor ; blood ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Gastric Juice ; chemistry ; Gastritis, Atrophic ; blood ; metabolism ; Humans ; Male ; Middle Aged ; Phytotherapy ; Precancerous Conditions ; blood ; metabolism ; Stomach Neoplasms ; blood ; metabolism

Objective To investigate characteristics and alternation of cerebral evoked potentials (CEP) response to esophageal mucosal acid exposure and distention in patients with non-erosive gastro-oesoph- ageal reflux disease (NERD) and in healthy subjects,and to study the mechanism of visceral hypersensitivity in NERD.Methods Twenty-one NERD patients and 10 volunteers were recruited.Mechanical distention stimulation and acid perfusion of the esophagus were performed using the balloon-affixed and polyvinyl multi- lumen catheter.First,maximally tolerated pain thresholds of all subjects were recorded,then esophageal mechanical stimulation with a 75% of maximal tolerated intensity and a frequency of 0.2 Hz was performed altogether 64 times by means of a computer-controlled barostat.The alternation of esophageal CEP was recorded before and after acid perfusion with a multichannel international 10-20 system of electroencephalography. Experimental data was analyzed by student's t-test and one way analysis of variance.Results Esophageal mu- cosal distention may evoke recognizable and reproducible and multi-peak CEP.The latencies for N1,P1 and N2 in volunteers were (246?77),(388?84)and (502?78) ms,CEP morphology of NERD patients was charac- terized by randomly distributed patterns,and the latencies for N1 ,P1 and N2 were (192?46),(293?76) and (440?79)ms,significantly shorter for mechanical stimulation compared with those of control group respectively (all P value

Objective To investigate the glucose metabolic pattern of brain functional loop in patients with refractory obsessive compulsive disorder (OCD) using 18 F-FDG PET.Methods Eight patients with refractory OCD and 8 age- and gender-matched healthy volunteers underwent 18F-FDG PET brain imaging.SPM software was used for image post-processing and quantitative analysis.Correlation analysis between 18F-FDG uptake and Yale-Brown obsessive compulsive scale(Y-BOCS) score was performed.Results Compared with the controls,the glucose metabolism of bilateral frontal cortices ( including the rectal gyrus,orbital gyrus and cingulate gyrus),left thalamus,right temporal lobe and bilateral cerebellum in refractory OCD patients increased significantly ( Zmax =3.45 - 5.80,all P ＜ 0.001 ).Bilateral motor cortices and bilateral parietal lobes (BA7),however,showed decreased glucose metabolism (Zmax =3.44 - 4.46,all P ＜0.001 ).Y-BOCS score was positively correlated with the glucose metabolism of the bilateral anterior cingulate cortex (Zmax =3.77,3.48 and 2.97,all P ＜ 0.01 ).Conclusions There is a characteristic metabolic pattern of increased glucose utilization in the fronto-striato-thalamic loop and decreased glucose utilization in bilateral motor cortices and parietal lobes in patients with OCD.The glucose metabolism in the anterior cingulate cortex might serve as a quantitative parameter for the assessment of the severity of OCD.

Adolescent ; Adult ; Antigens, CD ; metabolism ; Antigens, CD1 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Infant ; Lectins, C-Type ; metabolism ; Male ; Mannose-Binding Lectins ; metabolism ; Middle Aged ; S100 Proteins ; metabolism ; Survival Rate ; Young Adult

The mechanism of apoptosis induced by SIRT1 deacetylase inhibitors in both human breast cancer MCF-7 and MCF-7 doxorubicin-resistant cells was studied. MTT assay was used to detect growth-inhibitory effect on the cells. Protein expression was detected by Western blotting. Chromatin condensation was detected by a fluorescent microscope after Hoechst 33342 staining. Cell cycle distribution was analyzed with flow cytometry. Apoptotic cells were detected with Annexin V staining. Nicotinamide (NAM) and Sirtinol, two SIRT1 deacetylase inhibitors, exhibited the similar growth-inhibitory effects on MCF-7/DOX cells and MCF-7 cells, but no potentiation of DOX activities. The arrest at G2/M phase was detected by flow cytometry in both MCF-7 and MCF-7/DOX cells after NAM treatment. Activation of caspase pathway in MCF-7 cells, such as the cleavages of PARP, caspase-6, -7, -9, were observed after exposure to NAM 50 mmol x L(-1), accompanied by the occurrence of chromatin condensation and Annexin V positive cells. However, the cleavages of PARP, caspase-6 and -7 in MCF-7/DOX cells delayed after exposure to NAM for 24 h and obviously increased at 48 h with appearance of chromatin condensation and Annexin V positive cells. SIRT1 deacetylase inhibitors show no cross resistance to MCF-7 drug-resistant cells, and the similar growth-inhibitory actions of them to MCF-7 sensitive and drug-resistant cells by which it is mediated by activation of apoptotic caspase pathway.
Apoptosis ; drug effects ; Benzamides ; pharmacology ; Breast Neoplasms ; metabolism ; pathology ; Caspases ; metabolism ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Doxorubicin ; pharmacology ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Enzyme Inhibitors ; pharmacology ; Female ; Humans ; Naphthols ; pharmacology ; Niacinamide ; pharmacology ; Sirtuin 1 ; antagonists & inhibitors

OBJECTIVETo investigate the effects on erectile function of transplanted major pelvic ganglion into the corpus cavernosum of adult male rats undergoing transection of bilateral cavernous nerves.

METHODSTwenty-six male Sprague-Dawley rats (3 - 4 month-old and 300 - 400 g/each) were divided into 2 groups: experimental group (transection of bilateral cavernous nerves and transplantation of left ganglion into left crus of penis, n = 16) and control group (transection of bilateral cavernous nerves only, n = 10). Erectile function was measured by injecting APO, and intracavernous pressure was measured 1 and 3 months afterwards by electric-stimulating the right major pelvic ganglion or the left crus. Half animals in each group were sacrificed 1 and 3 months afterwards for detecting nNOS-containing nerve fibers of corpus cavernosum. Electron microscopy of the implanted area was performed to assess neuronal survival.

RESULTSBoth of the two groups have no erectile response to APO injection. Electrostimulation on the right major pelvic ganglion and left crus failed to produce erection in experimental group. The mean pressure changes in the two groups, measured by stimulating the left crus, were (9.41 +/- 3.20) and (4.16 +/- 2.58) cmH(2)O 1 month afterwards, and (13.67 +/- 4.18) and (5.09 +/- 2.74) cmH(2)O 3 months afterwards, respectively (P < 0.05). An increased number of nNOS-containing nerve fibers in left crus was detected in experimental group 1 and 3 months later, compared with control one (218.7 +/- 24.5, 18.0 +/- 3.7; 183.2 +/- 19.7, 19.0 +/- 3.8; P < 0.05). Ultrastructure examination by transmission electron microscope confirmed the survival of the implanted ganglion.

CONCLUSIONMajor pelvic ganglion can survive in the corpus cavernosum, and it has significant effects on the number of nNOS-containing nerve fibers and the alteration of intracavernous pressure.

Animals ; Autonomic Denervation ; Celiac Plexus ; surgery ; Ganglia, Autonomic ; transplantation ; Graft Survival ; Male ; Nitric Oxide Synthase ; metabolism ; Penile Erection ; physiology ; Penis ; innervation ; surgery ; Rats ; Rats, Sprague-Dawley ; Transplantation, Autologous

OBJECTIVETo evaluate the effect of pretreatment with finasteride in decreasing intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate (TURP).

METHODSEighty patients with benign prostate hypertrophy undergoing TURP were divided into two groups: 40 patients were pretreated with finasteride for 7 to 14 days before TURP and 40 patients without pretreatment. Absorption of irrigating fluid was quantified by analyzing the serum concentration of gentamycin. Intraoperative blood loss was calculated based on hemoglobin concentrations before and after operation.

RESULTThe whole blood loss, hemoglobin concentration of irrigating fluid used, blood loss per minute, blood loss per gram tissue resected, whole irrigation absorption, irrigation absorption per minute and per gram tissue resected in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05). The blood transfusion volume, the incidence of hypotension and hyponatremia in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05).

CONCLUSIONPretreatment with finasteride is of value in reducing intraoperative bleeding, irrigation absorption and perioperative complication during TURP.

Absorption ; Aged ; Blood Loss, Surgical ; prevention & control ; Finasteride ; therapeutic use ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Therapeutic Irrigation ; Transurethral Resection of Prostate