The reform for medical insurance payment was the important method for standardizing medical service provider behavior,controlling costs and improving efficiency,which was also the important measurement for further improve and implement the reform of drug and health system.Since the new medical reform in 2009,the central and local government had paid more attention on the role of medical insurance payment reform.Local medical departments of different places implemented reform pilots.Through summarizing the foreign and domestic researches around capitation,bundle payment and global payment,the experiences and effectiveness of these pilots were evaluated so as to provide corresponding policy implications.

Objective To explore the clinical characteristics and treatment of infants with cytomegalovirus(CMV)pneumonia.Methods The clinical and auxiliary examination data of 24 patients with CMV pneumonia,which were diagnosed by detection of serum CMV-IgM used enzyme immunodot technique.All patients were treated with ganciclovir (GCV).Results The most common clinical manifestations of CMV pneumonia were cough,breathlessness,fever,crackles and wheezing rale.Chest X-ray findings predominately revealed increased and thickened bilateral lung markings and patchy areas of increased opacity in both lungs.Sixteen cases were cured,8 cases improved.Conclusions Clinical manifestations of infant CMV pneumonia lack specificity.The presence of serum CMV-IgM antibody is a laboratory diagnostic evidence.GCV is the best choice of drug in treatment of infants with CMV pneumonia.

Objective To determine the in vitro effects of the traditional Chinese medicines, berberine, matrine and baicalin, on the proliferation and lipid synthesis of human immortalized sebocyte SZ95, and to investigate their possible mechanisms of action on sebaceous glands at the cellular level. Methods Inverted microscopy was used to observe cell morphology and determine toxic concentrations of the compounds. The MTT method was adopted to examine the effects of different concentrations of berberine, matrine and baicalin on SZ95 cell proliferation after 24 h, 48 h and 72 h of incubation. Lipid contents in the SZ95 cells were labeled with Nile red and analyzed by flow cytometry. Results The toxic concentrations were 1?10-3 mol/L, 1?10-4 mol/L, 1?10-3 mol/L for baicalin, berberine and matrine, respectively. Berberine reduced sebocyte proliferation in a dose- and time-dependent manner, with an inhibitory concentration 50 (IC50) of 2.9?10-5 mol/L and 1.4?10-5 mol/L after 48 h and 72 h of incubation, respectively. When the concentration of matrine was 0.05). Lipogenesis of SZ95 cells showed a 26.9% increase with 1?10-3 mol/L matrine. Conclusions Our results indicate that berberine and baicalin can inhibit proliferation and lipid synthesis of SZ95 sebocytes in vitro, which suggests a possible clinical role in treating acne.

Objective To compare the expression of serum miR-100 in patients with esophageal cancer and healthy person ,and explore the value of miR-100 in diagnosis for esophageal cancer .Methods Real-time fluorescent quantitative polymerase chain reac-tion was used to detecting miR-100 in 40 esophageal cancer patients(study group) and 50 healthy person(control group) .Results The expression of miR-100 in the study group and control group were 6 .399 ± 3 .541 ,2 .625 ± 1 .515 respective ,the expression in the study group was significant higher than that of the control group(t= 9 .07 ,P< 0 .05) .The under area of receiver operating char-acteristic curve of miR-100 in diagnosis for esophageal cancer was 0 .832(95% confidence interval was 0 .731 - 0 .934) ,when the Cut off value was 5 .285 ,the sensitivity and specificity of miR-100 in diagnosis for esophageal cancer were 65% and 95% . Conclusion Serum miR-100 in esophageal cancer patients is higher than that in healthy person ,which might be a new molecular markers in diagnosis for esophageal caner .

The 10-month baby boy,with normal development,mainly due to sleep in frequent tongue bite nearly 4 months.Bitten his tongue after faring asleep,biting bleeding,bite pain awake.Many of his tongue ulcers,serious impact on children's lives,family companionship in suffering.History found in the supplementary week before the onset of the left frontal children hurt skin bruising.Electroencephalogram showed:Sleep of epileptiform discharges in the left frontal and central anterior temporal areas,but bite the tongue during sleep electroencephalogram synchronization no relevant abnormal discharge.The final diagnosis of traumatic epilepsy,frontal lobe epilepsy syndrome automatically lead to tongue bite tongue with traumatic ulcers.Oral Clonazepam 0.25 mg before sleep,the symptoms disappeared that night,nighttime sleep peacefully.His tongue ulceration has healed after a month.Readers are advised to take advantage of these key parts of the diagnostic process and diagnostic thinking or diagnostic procedures,combined with their own clinical practice,serious thinking,learning,summarized,and benefit from it.

Objective To explore the expression and diagnostic value of serum microRNA-574-3p (miR-574-3p) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).Methods A total of 90 patients with HBV-related HCC,40 patients with HBV-related liver cirrhosis (LC) and 50 healthy controls were recruited.The expression levels of serum miR-574-3p,α-fetoprotein (AFP) and α-Lfucosidase (AFU) of all subjects were determined.The difference of serum miR-574-3p level between groups was compared.The relation between serum miR-574-3p level of HCC patients and its clinical pathological characteristics was analyzed.The t-test was performed.The relationship between serum miR-574-3p level of HCC patients and AFP,AFU was analyzed by Spearman correlation analysis.The diagnostic efficacy of them as diagnostic markers was evaluated by receiver operating characteristic curves (ROC) and the area under the curve (AUC)(95％ CI (confidence interval)).Results The relative quantity expression of serum miR-574-3p of HCC group,LC group and healthy group was 2.152(1.654,3.061),1.292 (0.984,1.666) and 1.018 (0.750,1.726),respectively.The expression level of serum miR-574-3p of HCC group was significantly higher than those of LC group and healthy control group,and the differences were statistically significant (t=2.726 and 2.845,both P＜0.01).The expression level of serum miR-574-3p of HCC patients was significantly different in tumors with different degree of differentiation (t=2.262,P=0.039),different stage (t=2.354,P=0.025) and different HBV DNA concentrations (t=2.771,P＜0.01).There was no correlation between serum miR-574-3p level and AFP (r2 =0.076,P=0.505),AFU (r2 =0.082,P=0.422) in HCC patients.When compared HCC group with LC group,AUC of serum miR-574-3p of was 0.823 and 95％ CI was 0.750 to 0.897.When compared HCC group with healthy control group,AUC of serum miR-574-3p was 0.840 and 95％CI was 0.769 to 0.910.Conclusions The expression level of serum miR-574-3p of HCC patients is significantly higher than those of LC patients and healthy controls.Serum miR-574-3p may be an important biomarker in the diagnosis of HCC.

To study the protective effect of Danshen Tongluo capsule on rat hearts in the myocardial infarction (MI) model. After being fed with high fat diets for one month, the SD rats were randomly divided into the sham group and the model group according to the left ventricular ejection fraction (EF). The MI model group was duplicated by ligating coronary artery and then divided into five groups: the model group, the positive control group (model + captopril), the small dose group (model + Danshen Tongluo), the medium dose group (model + Danshen Tongluo) and the high dose group (model + Danshen Tongluo). Four weeks later, changes in myocardium ultra-structure were observed by hemodynamics, cardiac ultrasound and electron microscope. The results showed: (1) All doses of Danshen Tongluo capsule could significantly reduce the left ventricular end diastolic pressure (LVEDP) (P <0.01), increase the maximum internal pressure of the left ventricle (+ dp/dtmax), and lower the drop rate of left ventricular pressure (- dp/dtmax), with statistical significances in medium and high dose groups; (2) The B ultrasound results showed increase in EF and left ventricular shortening fraction (FS) in all dose groups of Danshen Tongluo capsule; (3) The medium dose group showed significant decrease in myocardial infarction index (P <0.01) and injured and fractured myofilament and sarcomere of ischemic myocardium in myocardial ultra-structure; All of Danshen Tongluo capsule-treated groups revealed reduction in myocardial injury and myocardial infraction area. The study preliminarily proves that Danshen Tongluo capsule can improve hemodynamic function, and has a protective effect on myocardial ischemia.
Animals ; Capsules ; Drugs, Chinese Herbal ; therapeutic use ; Hemodynamics ; drug effects ; Male ; Myocardial Infarction ; drug therapy ; pathology ; physiopathology ; Myocytes, Cardiac ; ultrastructure ; Rats ; Rats, Sprague-Dawley ; Ventricular Function, Left ; drug effects

Coronary artery disease (CAD) is one of the leading causes of death. Safflower attracts great attention owing to its anti-ischemia/reperfusion injury effect. Ninety-three patients with CAD were included and randomized into safflower treatment group, PCI group and control group. Low-dose dobutamine stress echocardiography (DSE) was performed to measure end-systolic volume (ESV), end-diastolic volume (EDV), left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) to determine the recovery of hibernating myocardium and cardiac function in all patients before treatment and after 3-month follow-up. The study was to investigate the effects of safflower on hibernating myocardial revascularization and cardiac function. It was found that LVEF was significantly improved, while the ESV and WMSI were significantly reduced after 2-week treatment in safflower and PCI treatment groups. No significant differences were found between safflower and PCI treatment groups in ESV, EDV, WMSI and LVEF after treatment Safflower injection effectively improved hibernating myocardial function.
Aged ; Carthamus tinctorius ; chemistry ; Coronary Artery Disease ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Heart ; drug effects ; physiopathology ; Humans ; Male ; Middle Aged ; Myocardial Revascularization ; Myocardial Stunning ; drug therapy ; physiopathology ; surgery ; Recovery of Function

85 mL/min),CL=6.0?(WT/60)~(0.52).④The increased volume of peripheral distribution (V_2) was observed when norvancomycin was co-administered with diuretics;④Reduced drug clearance,prolonged t_(1/2),and increased values of AUC_(24) were found in elderly patients.Conclusions Renal function impairment and age have significant impact on PK parameters of norvancomycin.Dosing regimens of norvancomycin were finally established for different patients on the basis of important PPK parameters generated from different groups of patients.

Objective To study the effects of tanshinone on the cultured immortalized human sebocytes and explore the mechanism of action of tanshinone in the treatment of acne. Methods MTT assay was applied to determine the effects of cryptotanshinone and tanshinone Ⅱ? at different concentrations on the proliferation of SZ95 sebocytes in 24 h, 48 h and 72 h after incubation. Lipid contents labeled with Nile red in SZ95 cells were analyzed by flow cytometry technique, and the expression of androgen receptor (AR) mRNA of SZ95 cells were detected by RT-PCR. Results Both cryptotanshinone and tanshinoneⅡ? inhibited the proliferation of SZ95 cells in a dose- and time-dependent mode, with the 50% inhibition concentration (IC50) of 7.473 ?mol/L (in 48 h) and 2.146?mol/L (in 72 h) for cryptotanshinone and 6.021 ?mol/L (in 48 h) and 2.25 ?mol/L (in 72 h) for tanshinone Ⅱ?. Additionally, as compared with the control group, the lipid content of SZ95 cells exposed to tanshinone Ⅱ? at 0.125?mol/L was decreased in 48h (P