As a mode of pay for performance,hospital value-based purchasing has been become widespread the US.Medicare managed to encourage the service providers to provide medical services with more value and quality.The implementation background,financing,payment mode and performance evaluation of hospital value-based purchasing were briefly introduced.In the payment reform of China,it also needed to focus on the medical service quality,learn from the performance evaluation system,incentive mechanism and multiple measurement,reasonably design the implementation scheme.

By improving the existing pattern that different medical institutions with competition fragmentary health care mode,the bundled payment could improve the coordination and cooperation between medical institutions,improve the overall medical service quality and reduce medical service cost.It provided a helpful thought for the supply-side reform in health field in China.Foreign experience indicated that in order to implement bundled payment mode,China should build a complete medical service supply chain to promote integration of medical institutions;shift economic stimulus to economic constraints,build orderly competition environment;strengthen the construction of informatization and promote the applications of healthy big data.

Adult ; Carbodiimides ; poisoning ; Humans ; Male ; Methylamines ; poisoning ; Occupational Exposure ; Young Adult

PURPOSE To investigate the methylation of p53 gene in human thyroid carcinoma. METHODS The DNA of 12 thyroid carcinomas and 5 adjacent tissues of thyroid carcinoma were digested by restriction endonuclease enzymes Hap I and Msp I . Polymerase chain reaction (PCR) followed by agarose gel electrophoresis was used to detect the methylation in the exon 5 of p53 gene. RESULTS 5'-CCGG-3' site was methylated at the exon 5 of p53 gene in 9 thyroid carcinomas. However hypomethylation was found to exist in 5 adjacent tissues of thyroid carcinoma. CONCLUSION Hypermethylation of p53 gene plays an important role in thyroid carcinogenesis and the mutation of p53 gene.

Objective To investigate the impact of photodynamic therapy (PDT) with verteporfin on the expression of pigment epithelial derivative factor (PEDF) mRNA and vascular endothelial growth factor (VEGF) mRNA in adult retinal pigment epithelial (RPE) cells in vitro. Methods The changes of cellular viability before and after PDT were assessed by methyl thiazolyl tetrazolum (MTT) colorimetric assay. Semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) was conducted to detect the expression of PEDF and VEGF mRNA in RPE cells before and after PDT. Results PDT caused the death of RPE cells. The cellular mortality was positively correlated with the power of photocoagulation and the concentration of verteporfin. Conclusion PDT could down-regulate the expression of PEDF and VEGF mRNA in adult RPE cells in vitro, which may relate to the cure or relapse of subfoveal choroidal neovascular membrane after PDT.

Objective To observe effect of astragalus injection on levels of blood selenium,T cell immunity function and cytokines with viral myocarditis in children. Methods Fourty two patients with viral myocarditis in children, receiving the therapy of Astragalus injection Observing the levels of blood selenium and cytokine, including interleukin-1 (IL-1), IL-6, tumor necrosis factor-alpha (TNF-?),and including estimation of T lymphocyte subsets and cardiac function too. Results The result showed that in post-treatment, the levels of blood selenium were significantly higher (P

Objective To construct luciferase reporter plasmid containing synthetic CArG elements and to investigate their radiation-inducible property in tumor cells. Methods Insert chimeric regulation elements consisting of nine tandem-repeat copies of CArG sequence (CCATATAAGG) and CMV IE basal gene promoters into pGL3-Basic vectors to construct luciferase reporter plasmids. Tumor cells(HeLa, A549 and HepG2) were transiently transfected by reporter plasmids using lipofectamine, and transfected cells were irradiated by ?-ray with different doses. After 36 h, we assayed the level of reporter gene expression. Results The CArG elements could successfully induce the expression of a downstream reporter gene following irradiation, with maximal expression seen after 3 Gy irradiation. Conclusion The synthetic CArG elements are responsive to low dose of radiation and are able to enhance down-stream gene expression. It is expected to be the essential potential for future application of radiogenetic cancer therapy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Combined Modality Therapy ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Male ; Massage ; Middle Aged ; Young Adult

AIM: To study the effect of crocetin on the formation of advanced glycation end products(AGEs) and receptor for AGEs(RAGE) protein expression in diabetic rats induced by streptozotocin(STZ).METHODS: Rats were injected STZ in tail vessel with a dose of 45(mg?kg~(-1)).3 d later,the rats whose blood glucose were over(11.1)(mmol?L~(-1)) were regarded as diabetic rats,and were divided randomly into two groups: diabetic mellitus(DM) group,crocetin(50(mg?kg~(-1)),po) group.At the same time,8 normal rats were regarded as control group.After 21 d treatment,The levels of fasting blood glucose(FBG),serum fructosamine(FMN) and glycosylated hemoglobin(GHb) were measured.The contents of AGEs in aorta and mesenteric vessel were detected by fluorospectrophotometry.HE staining for mesenteric aorta was performed,and RAGE protein expression was studies with immunohistochemical method.RESULTS: Compared with DM group,crocetin did not decrease the level of FBG.However,it could decrease the levels of FMN and GHb in blood and AGEs in aorta and mesenteric vessel(P

Aim To investigate the effect of oral itraconazole on pharmacokinetics of viaminate and under-stand the metabolism pathway of viaminate in healthy humans,as well as guide the reasonable medication for viaminate and itraconazole coadministration.Methods The study was conducted in a double-blind randomized and crossover manner with two phases of treatment with placebo-viaminate or itraconazole-viaminate.Eight healthy male subjects received an oral dose of 200 mg itraconazole(QD) or matched placebo for five consecutive days,and took an oral 100 mg dose of viaminate on day 4 after each treatment phase.The liquid chromatography-mass spectrometry(LC-MS) was established to measure the blood drug concentration of viaminate.Results Our results showed that the mean peak concentration of viaminate was increased with itraconazole [(21.21?11.65) ?g?L~(-1) vs(27.12?13.83) ?g?L~(-1),P0.05].Additionally,the mean elimination half life was prolonged [(2.71?0.38) h vs(4.43?0.93) h,P