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 syndrome distribution laws of refractory idiopathic thrombocytopenic purpura (RITP), and the relevance between various syndromes and gender, age, laboratory indicators, to reveal the essence of TCM syndrome and provide a reasonable and standard TCM treatment principle. Methods TCM syndrome, gender, age and laboratory indicators of 75 cases of RITP were studied retrospectively and analized statistically. Results Qi deficiency and blood stasis is the major syndrome, and Yin deficiency is the secondary syndrome. Compare with others, the patients with qi deficiency and blood stasis syndrome were older, and had longer disease courses and more severe conditions. Conclusion One of TCM intervention treatment principles for RITP is invigorating qi and yin, promoting blood circulation and removing blood stasis.

Animals ; Galanin ; administration & dosage ; antagonists & inhibitors ; pharmacology ; Patch-Clamp Techniques ; Peptide Fragments ; administration & dosage ; pharmacology ; Rats ; Rats, Wistar

OBJECTIVE:To investigate the clinical characteristics and gene polymorphism of oxcarbazepine (OXC)- induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). METHODS:Retrieved from CNKI,Wanfang,VIP, PubMed,EMBase,SpringerLink and other databases,case reports about OXC-induced severe ADR were summarized and ana-lyzed. RESULTS:Twelve literatures were collected,and 13 case reports about OXC-induced SJS/TEN were obtained. Male had more OXC-induced severe skin ADR than female. ADR mostly occurred during 1-14 d after medication. All patients were cured with treatment of glucocorticoid and antiallergy,without death case. Genotyping for 8 patients were performed and 6 of them showed the presence of HLA-B*1502 allele. While HLA-B alleles of 2 patients were HLA-B*1518/B*4001,which was the variation of HLA-B*1502. CONCLUSIONS:OXC-induced ADR should be monitored closely. Great importance should be attached to patient education and follow-up program. HLA-B*1502 gene detection should be performed to guide rational use of OXC and optimize clini-cal drug use plan.

Air ; Animals ; Diving ; Male ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Spleen ; metabolism

Objective To measure the levels of caspase-1 and its downstream factor interleukin (IL)-18 and IL-33 in rheumatoid arthritis (RA) and explore their possible mechanisms.Methods Blood samples were drown from 56 patients with RA and 22 healthy subjects.Serum levels of caspase-1,IL-18 and IL-33were tested by the method of enzyme linked immunosorbent assay (ELISA).Kruskal-Walls and Mann-Whitney test were used to compare the levels of caspase-1,[L-18 and IL-33 and Spearman's correlation test was used for correlation analysis.Results The level of caspase-1 was significantly increased in RA group compared to healthy group [(32±26) ng/ml vs (15±6) ng/ml,P＜0.01].Meanwhile,the active disease groups showed a higher level than the remission group,and level in the untreated group was higher than the treated group [(47±27) ng/ml vs (25±22) ng/ml,P＜0.01].The levels of IL-18 and IL-33 were significantly increased in RA group compared to healthy group [(121±121) ng/L vs (58±33) ng/L,(1032±1011) ng/L vs (510±231)ng/L,respectively,P＜0.05].Meanwhile,the active disease groups had a higher level than the remission group and the untreated group had higher levels than the treated group [IL-18 and IL-33 were (172±139) ng/L vs (97±106) ng/L,(1469±1039) ng/L vs (825±941) ng/L,respectively,P＜0.05].Caspase-1 was correlated withIL-18 and IL-33 (r=0.824,0.854,P＜0.01) and IL-18 was correlated with IL-33 (r=0.800,P＜0.01).But neither of the three factors was related with clinical indexes including disease duration,RF,anti-CCP antibody,tender joints count and swollen joints count.Conclusion Caspase-1 and its downstream factor IL-18,IL-33 increase in RA,and they may play important roles in RA.

AIM: To provide experimental evidence for gene therapy of thrombophilia disease, we constructed the eukaryotic expression plasmid with human thrombomodulin (hTM) gene and observed the alteration of hTM expression on the surface of human umbilical vein endothelial cells (HUVECs) with and without the reconstructive plasmid. METHODS: The whole expressive fragment of hTM gene was amplified by PCR from human genome. Both hTM gene and pcDNA3.1(+)/neo empty vector was digested by HindⅢ and EcoRⅠ. Two digested fragments were ligated into pcDNA3.1/hTM with T_4DNA ligase. After identifying, the reconstructive plasmid transfected into HUVECs using lipofectin. The hTM antigen on the HUVECs was detected by immunohistochemistry. RESULTS: The hTM reconstructive plasmid was confirmed by double endonuclease redigesting and sequencing. About 10% HUVECs were transfected by pcDNA3.1/hTM plasmid with lipofectin and the high-level hTM was detected on the transfected cells. CONCLUSION: We constructed the pcDNA3.1/hTM plasmid successfully, and it could be expressed on the HUVECs. [

Objective To establish a method for the preparation of long-circulating liposomes (LCL) containing etoposide and to observe its stability in rats plasma.Methods The etoposide-containing liposome was prepared by ethanol injection method. Polyethylene glycol-distearoyl phosphatidylethanolamine (PEG2000-DSPE) was used to modify the membrane of the liposome. Reversed-phase high pressure liquid chromatography (RP-HPLC) was used to detect the concentration of the liposome,and dynamic release method was used to study its stability in mice plasma.Results The mean size of the LCL containing etoposide was (180?26) nm,and the mean concentration of etoposide was (4.78?0.22) mg/mL,with the entrapment efficiency being (88.71?8.2)%. The leakage ratio of the conventional liposome containing etoposide and LCL containing etoposide in mice plasma were (80.14?1.59)% and (46.72?2.61)%,respectively.Conclusion LCL containing etoposide with high entrapment efficiency and low leakage rate can be obtained by using ethanol injection method. Additionally,modification by PEG2000-DSPE could raise the stability of the liposome.

As a landmark masterpiece in the development of acupuncture-moxibustion history,Zhen Jiu Jia Yi Jing (A-B Classic of Acupuncture and Moxibustion) has been studied by numerous scholars. This article tried to find out the acupoints selection rules for heat diseases inA-B Classic of Acupuncture and Moxibustion by taking the heat diseases as the focus and using statistical methods, for promoting the application in clinic.

[Objective]To study whether Cervus and Cucumis Polypeptide(CCP ,Lugua polypeptide) can treat osteoporosis or not. [Methods]Forty 4-month-old female SD rats were randomized into four groups(10 in each group) ,including SHAM,0VX, OVX+CCP1 and OVX+CCP2 groups. Male rats in OVX groups take the ovariectomized surgery. Since the 13th week, rats in groups A and B got 0.9% physiological saline injection once in a day, group C was treated with CCP 0.4mL/(kg·d)injection and group D treated with CCP0.8mL/(kg·d) injection once one day. Twelve weeks later, al rats were sacrificed for obtaining specimen. Took right femurs, measured the bone biomechanical properties. [Results ]After 12 weeks since injection, the biomechanical property of right femurs in group OVX was significantly lower than that of the SHAM group( P<0.01); parameters such as maximum load and elastic load in group OVX+CCP1 and OVX+CCP2 were higher than that of group OVX(P<0.05), but lower than that of group SHAM(P<0.05). The distinction of the above parameters was significant( P<0.05)between group OVX+CCP1 and OVX+CCP2. [Conclusion]1.CCP can significantly im-prove the bone internal biomechanical properties in ovariectomized(OVX) rats, so it has function to treat osteoporosis caused by drop in estrogen level. There are differences of bone biomechanical properties aspects when treated with different dosage of CCP, which shows the tendency of dose-dependent effect. So we can conclude that CCP may have dose-dependent effect.