Objective To investigate the current policy of medical insurance expenditure control in Shanghai and put forward feasible advice. Methods Survey in 5 tertiary first-class hospitals in Shanghai involving 400 doctors and patients was conducted.The result of the questionnaire was tracked with Microsoft Excel 2000.The expense reports during 2001 to 2006 from the Office of Medical Insurance of Shanghai Renji Hospital was collected.All the data were statistically analysed. Results The global budget system was accepted by both the doctors and patients.Charging based on disease categories was proved a relatively satisfying method.Drug expenditure control was concerned by both the doctors and patients. Conclusion Ever since the global budget system of medical insurance is implemented in Shanghai,the medical insurance expenditure has been effectively controlled.The key point is the restraint of irrational consumption during the medical treatment.

0.05).The mean hospital stay of PCN group was significantly shorter than that of conservative treatment group(4.5 days and 16.5 days respectively(P

Adolescent ; Anti-Arrhythmia Agents ; therapeutic use ; Child ; Child, Preschool ; Echocardiography, Doppler, Color ; Electrocardiography ; Exercise Therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Treatment Outcome ; Ventricular Premature Complexes ; diagnosis ; etiology ; therapy

Evidence-based medicine is advocated by WHO and adopted by developed countries for many years. In China, however, the selection of essential medicine and various medical insurance reimbursement schemes medicine is usually based on experts' experience of prescription practice which is under heavy critics resulting from the lack of related comparative efficacy and evidence-based research. The efficacy of Jian'ganle in prevention of drug-induced liver injury (DILI) caused by antituberculotics was evaluated in this study by comparison with Hugan Pian, glucuronolactone and reduced glutathione. Evidence was provided for relevant sectors such as Ministry for Human Resources and Social Security of the People's Republic of China and National Health and Family Planning Commission of the People's Republic of China to select and renew the Essential Medicine List (EML), the new rural cooperative medical scheme in China (NRCMS) list or the reimbursement list of industrial injury insurance. A total of 189 patients with initial pulmonary tuberculosis were divided into four groups who took antituberculotics combined with Jian'ganle, Hugan Pian, glucuronolactone and reduced glutathione respectively. Their liver function profile including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), total protein (TP), albumin (A) and globulin (G) were detected at admission as baseline and after treatment. The Jian'ganle group was compared with the three others by chi-square tests. In an aspect of maintaining bilirubin indexes normal, Jian'ganle was more efficacious than glucuronolactone. And Jian'ganle had a little more efficacy than reduced glutathione to maintain protein indexes normal as well. And the therapeutic regimen of antituberculotics combined with Jian'ganle was the best in treating tuberculosis and preventing DILI at the same time. The study showed that among the four hepatinicas which demonstrated similar prevention of DILI caused by antituberculotics, Jian'ganle has more advantages over the three others to some extent, which provides a reliable basis for health sectors to select and renew the EML, NRCMS List or the reimbursement list of industrial injury insurance.

Acupuncture Therapy ; Adult ; Antidepressive Agents, Tricyclic ; therapeutic use ; Clomipramine ; therapeutic use ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Obsessive Behavior ; therapy

Administration, Topical ; Adult ; Aged ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Pruritus ; drug therapy ; etiology ; Renal Dialysis ; adverse effects ; Renal Insufficiency ; therapy

Objective To investigate the clinical and pathological features of patients co-infected with hepatitis B virus(HBV)and hepatitis C virus(HCV)and to study the underlying interaction between HBV and HCV in these patients.Methods The liver biopsy and sera samples of 226 patients with chronic hepatitis were collected.Real-time fluorescent quantitative polymerase chain reaction were used tO measure HBV DNA and HCV RNA,respectively.Enzyme-linked immunosorbent assay (ELISA)was utilized to detect HBV serological marker and anti-HCV antibody.Liver biopsy examination was performed through needle aspiration.HBsAg and HBcAg in liver tissue were detected by immunohistochemistry,while HBV DNA and HCV RNA were detected by in situ hybridization.Results Sixty two point five percent patients co-infected with HBV and HCV suffered from severe hepatitis,while the rates of those infected with HBV or HCV alone were 27.1%and 30.6%,respectively(X2=14.70,P＜0.01).The serum alanine aminotransferase,aspartate aminotransferase, total bilirubin.direct bilirubin and albumin levels of patients infected with HBV alone were higher than those of patients co-infected with HBV and HCV or those infected with HCV alone,which showed statistically significant difference(X2=8.52.P＜0.05).The HBsAg titers in serum samples and in liver tissue samples were inconsistent in both co-infected patients and HCV mono infected patients (X2=15.60,P＜0.01).The HBV DNA positive rate of co-infected patients was 12.5%,which was lower than that of patients infected with HBV alone(87.7%,X2=17.66,P＜0.01).Meanwhile,the HCV RNA positive rate of patients co-infected with HBV and HCV was 75.0%,which was lower than that of patients infected with HCV alone(80.6%).However,the difference was not statistically significant(P＞0.05).Conclusion Co-infection with HBV and HCV may induce severer liver injury than HBV infection or HCV infection alone.

Objective:To determine whether implantation of an intraocular lens(IOL) with a modified prolate anterior surface results in reduced spherical aberration and improved contrast sensitivity after cataract surgery.Methods: Consecutively 72 eyes were selected from 53 senile cataract patients who had received phacoemulsification and IOL implantation in Peking University Eye Center.Each was randomly assigned to receive Tecnis Z9001 IOL or Sensar AR40e(both made by AMO).Three months after operation,the eyes underwent several tests including visual acuity,optometry and wavefront aberration examination.Mesopic contrast sensitivity test was measured with ROLAND BA-4 Contrastometer.Results: The eyes treated with Tecnis Z9001 had significantly less spherical aberration.The eyes treated with Tecnis IOL got lower C12 coefficient and RMS4 than those with Sensar AR40e(P value

Objective To evaluate the value of mistral-air inflatable blanket in neonatal temperature,postoperative complications,and the influence of the blood coagulation function after surgery undergoing general anesthesia.Methods A total of 60 newborns with laparotomy operation undergoing general anesthesia were randomly divided into two groups,the control group and the observation group,30 persons each group.The newborns were given mistral-air inflatable blanket in the observation group,and conventional methods in the control group,two groups were transferred to Postanesthesia Care Unit by incubator at 37℃.The introperative nasopharyngeal temprature,HR,MAP and SpO2 were recorded before induction (T0),30 minutes during operation (T1),extubated instantly (T2),15 minutes during PACU (T3),30 min during PACU (T4).The extubation time and the incidence of apnoea and hyoxemia were recorded after operation.PT,APTT,TT and Fib were tested before induction and extubated instantly.Results The temperature of intraoperative and postoperative period were higher in the observation group than the control group,the difference was significant(P ＜ 0.05).The heart rates of intraoperative and postoperative period is significantly higher in the control group than the observation group,the difference was significant(P ＜ 0.05);the mean arterial pressure were no significant statistical difference(P ＞ 0.05).The observation group extubation time were less than the control group,the difference was significant (P ＜ 0.05).There was no significant difference about the incidence of hypoxemia and apnea in two groups(P ＞ 0.05).The PT,APTT,TT and Fib in the observation group were better than the control group,the difference between the groups was significant(P ＜ 0.05).Conclusion Mistral-air inflatable blanket can effectively prevent the decrease of the body temperature during operation and PACU,reduce the exduction time and postoperative complications,and protect blood coagulation function.

The strain of DG7 isolated from the oilwater sample in DAGANG oilfield could produce surfactant ?acids and gas in the culture medium in which the diesel was sole carbon source .The strain was Gram-negative, motive, rod and growed facultatively in the 0 to 18.5% NaCl. Based on its characters, the strain was identified as a member of the genus Aeromonas, but there were some differences between this strain and the described species of this genus in some biochemical features, suggesting that it could be a new species of the genus.