The reimbursement on high-value drug expenses for patients is an important approach of catastrophic disease medical insurance.Hong Kong has established in a drug safety network, that has achieved remarkable results in improving the accessibility to high-value drugs and the burden of disease and effectively alleviated patients' financial burden.This paper systematically analyzes the history, process of adding drugs to directory, application conditions for drugs and patients, development status, and characteristics of drug safety network in Hong Kong.This study points out that although Mainland China has gradually established the high-value drug directory for catastrophic disease through the method of drug negotiation, the mechanism of high-value drug directory is not mature yet.To achieve the convergence between high-value drug directory, basic medical insurance drug directory, and new rural cooperative medical scheme drug directory, Mainland China needs to: 1) First, learn from the drug safety network in Hong Kong and establish access and exist mechanism for high-value drug directory;2) Then, expand insurance coverage of high-value drugs by establishing a multi-channel and socialized financing mechanism;3) Finally, strengthen the major disease medical insurance by adhering to the principles of buying drugs and getting drugs for free and reforming the fixed-ratio-reimbursement model.

In this article we report the results on the synthesis and accumulation of PHAs by Rhodocista pekingensis (strain 3-p), a phototroph that was isolated from wastewater treatment plant. Our results showed that the optimal conditions for PHAs accumulation with strain 3-p were as following: 0.01% Yeast Extract, 0.01% NH 4Cl, Acetate 5 g/L, and medium pH of 7.0～7.2.Under optimized conditions, strain 3-p accumulated PHAs up to 60% of its cellular dry weight. Enzymatic activities of ?-ketothiolase, acetoacetyl-CoA reductase, and PHA polymerase were detected and their activities increased as PHA synthesis initialized. Based on these study, we proposed the metabolic pathway of this strain should be:Acetate (or other fatty acids) - Acetyl-CoA --- thiolase Acetoacetyl-CoA --- reductase D (-)-?-Hydroxybutyryl-CoA ----- PHA polymerase PHAs.

12 isolates of thermoacidophilies were obtained from samples of hot springs of Southern China's Guangdong and Yunna provinces. All isolates are heterotrophic. Cells are rods, Gram positive or variable. The optimal pH and temperature for growth are 3.5-5.5 and 43℃-52℃, respectively. Based on their morphological physiological properties and their 16S rDNA sequences, they were identified as members of Alicyclobacillus.

Abstract: Objective　To analyze the epidemic characteristics of etiologically positive pulmonary tuberculosis, and the outcome of treatment in Liaoning Province from 2016 to 2022, aiming to provide a scientific basis for the formulation of tuberculosis prevention and control measures in Liaoning Province. Methods　The medical records information of registered pulmonary tuberculosis patients in Liaoning Province from 2016 to 2022 was collected from the "Tuberculosis Information Management System", a subsystem of the "China Disease Prevention and Control Information System". A descriptive analysis was performed on the epidemiological characteristics and treatment outcomes of cases of pathogen-positive pulmonary tuberculosis. Results　From 2016 to 2022, a total of 152 778 cases of active pulmonary tuberculosis were registered in Liaoning Province. Registration rates decreased from 54.48/100 000 in 2016 to 39.12/100 000 in 2022, displaying a downward trend (χ2trend=1 921.17, P<0.001). The etiological positive rate increased from 26.70% in 2016 to 51.21% in 2022, indicating an upward trend (χ2trend=5 203.00, P<0.001). The etiological positive registration rate increased from 14.54/100 000 in 2016 to 20.03/100 000 in 2022, showing an upward trend (χ2trend=647.97, P<0.001). The male-female ratio of etiological positive was 3.35∶1. The age group of 55-<65 had the highest incidence rate at 25.45% (16 127/63 376) among pathogen-positive pulmonary tuberculosis cases. Patients over 45 years of age accounted for 71.27% (41 570/63 376) of total cases, pointing towards an aging trend. The main occupations of the patients were household and unemployed, making up 41.78% (26 477/63 376) of total cases and showed an increasing year-on-year trend (χ2trend=17.404, P<0.001). Direct medical consultation was the primary mode of patient source at 50.28%(31 864/63 376), while 64.54%(40 904/63 376) cases reported a delay in seeking treatment. Seasonality was observed in the occurrence of pathogen-positive pulmonary tuberculosis, with February and September being the months of lowest incidence, while May and June witnessed peak incidences. The etiological positive patients were mainly in Shenyang, Dalian, Jinzhou and other regions. The proportion of successful treatment of etiologically positive decreased from 91.15% in 2016 to 85.88% in 2022, manifesting a downward trend (χ2trend=35.892, P<0.001). Conclusions　From 2016 to 2022, the incidence and registration rates of pathogen-positive pulmonary tuberculosis in Liaoning Province displayed an upward trend. Several characteristics were observed including seasonal variations, delayed treatment, regional distribution differences, and a decline in successful treatment rates. Targeted prevention and control measures should be formulated according to the actual situation in Liaoning Province.

?AlM: To observe the expression of Acin1 ( apoptotic chromatin condensation inducer 1 ) in congenital cataract mouse retina during development and investigate the differences of retinal apoptosis and the connection of lens and retina development between congenital cataract mouse and normal mouse.
?METHODS: There were congenital cataract mice ( 10 female and 5 male) and normal C57BL/6 mice (10 female and 5 male) . One male and two female mice were fed in the same cage randomly. The young mice were divided into two groups: congenital cataract group and normal control group. Five young mice were treated each group on 1, 5, 9, 14, 17, 21, 26, 60d. The left eyes were fixed with 4% neutral formalin to detect AClN1 protein by immunohistochemistry and retinas from right eyes were used to detect the mRNA expression of Acin1.
?RESULTS: Acin1 had sustained expression in each group. AClN1 protein gradually expressed from the ganglion cell layer, inner nuclear layer to the outer nuclear layer following retinal development. lt mainly expressed on ganglion cell layer and inner nuclear layer, but not neuroblastoma layer. AClN1 protein positive cells on P1 ~ P14d increased in normal control group, P17d reduced, after P21d positive cells of each layers decreased. The overall trend was similar in congenital cataract group with normal control group, P1 ~ P14d positive cells count was lower than normal control group, P17-P21d positive cells were flat and higher than the normal control group. Compared with the same day of the two groups, the differences except for P17, P26, P60d were significant (P<0. 05). The overall difference was statistically significant in congenital cataract group ( Fcataract=295. 07, P<0. 01);in addition to P1 and P5, P17 and P21, the differences were statistically significant ( P< 0. 05 ) compared with each other in congenital cataract group. The overall difference was statistically significant in control group (Fnormal=214. 21, P<0. 01); in addition to P1 and P5d, the difference was statistically significant ( P<0. 05) compared with each other in control group. The expression of P17d in congenital cataract group was lower compared with that of P14d in control group, the difference was statistically significant (P<0. 05). Acin1 mRNA trends of two groups were similar with AClN1 protein. Compared with the same day of the two groups, the difference was significant except for P17, P21, P60d (P<0. 05 ) . The overall difference was statistically significant in each other of the two groups ( Fcataract=522. 29, P<0. 01;Fnormal=472. 05, P<0. 01). The difference was statistically significant compared with each day in control group ( P<0. 05). Compared with all the rest of days except for P21 and P26d, the difference was statistically significant in congenital cataract group (P<0. 05).
?CONCLUSlON: Acin1 exist differential expression of time and space in mouse retina during development, congenital cataract crystal developmental disorder may affect the expression of Acin1 and retinal cell apoptosis and development.

Objective To investigate the clinical significance of thyroglobulin(TG) and thyroglobulin antibody (TGAb) in differential diagnosis between nodular goiter and differentiated thyroid carcinoma(DTC).Methods From Jan.2006 to Jan.2007,180 cases of thyroid carcinoma were included in group A(male:45,average age:47 ; female:135,average age:43)and 150 cases of nodular goiter were included in group B (Male:55,average age 43 ; female:95,average age:41).All the cases came from the General Department of Chengde Central Hospital.Group C (the control group) included 120 cases (male:40,average age:38 ; female:80,average age:44).All patients underwent thyroids ultrasound,thyroid function detection and CT.Results The positive rate of TG and TGAb was 40.0％ and 43.3％ in group A,which were obviously higher than those in group B (7.33％,9.33％)and group C(4.17％,7.50％).The difference had statistical significance(P ＜0.05).However,there was no statistical difference between group B and group C (P ＞ 0.05).Conclusion The measurement of TG and TGAb has clinical significance in differential diagnosis between DTC and nodular goiter.

Objective To investigate the application value of the preoperative progressive pneumoperitoneum (PPP) in parastomal hernia repair.Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients who underwent parastomal hernia repair using PPP in the Sixth Affiliated Hospital of Sun Yat-sen University from December 2014 to February 2017 were collected.Patients received abdominal computed tomography (CT) scan after admission,and volumes of the hernia sac and abdominal cavity and (volume of the hernia sac / total volume of the abdominal cavity)× 100.0％ were respectively calculated.Open or laparoscopic parastomal hernia repair was selected based on the effects of artificial pneumoperitoneum.Observation indicators:(1) PPP situations:① completion;② changes of volumes of the hernia sac and abdominal cavity before and after PPP;③ adhesion and retraction of parastomal hernia contents after PPP;(2) surgical and postoperative recovery situations;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative long-term complications and recurrence of parastomal hernia up to May 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Repeated measurement data were evaluated with the repeated measures ANOVA.Results (1) PPP situations:① completion:28 patients received successful ultrasound-guided indwelling catcher.Twenty-four patients completed PPP,with a completion rate of 85.7％ (24/28) and an air injection volume of (3 995±531) mL,and 4 stopped PPP.Eighteen patients had varying degrees of abdominal pain,abdominal distension and scapular pain,including 17 with tolerance and 1 with disappearing of symptoms at day 6.Of 5 patients with shortness of breath,3 were improved or well tolerated through breathing exercises,and symptoms of 2 disappeared at day 7 and 9.Three patients had mild subcutaneous emphysema.The arterial CO2 tension of 1 patient was high and then returned to normal at day 7.Some patients had simultaneously multiple adverse reactions.② Changes of volumes of the hernia sac and abdominal cavity before and after PPP:volumes of the hernia sac before and after PPP were (699± 231) mL and (993 ± 332) mL,with a statistically significant difference (F=129.29,P＜0.05),and increasing volume of the hernia sac was (294± 167) mL,with an increasing rate of 43％±15％.Volumes of the abdominal cavity before and after PPP were (6 520±745)mL and (9 196± 909) mL,with a statistically significant difference (F=429.42,P＜0.05),and increasing volume of the abdominal cavity was (2 715±709)mL,with an increasing rate of 42％± 12％.(Volume of the hernia sac / total volume of the abdominal cavity) × 100.0％ before and after PPP were 9.6％ ± 2.7％ (less than or equal to 10.0％ in 20 patients,more than 10.0％ and less than or equal to 15.0％ in 6 patients,and more than 15.0％ in 2 patients) and 9.7％± 2.8％,with no statistically significant difference (F =0.44,P＞0.05).③ Adhesion and retraction of parastomal hernia contents after PPP:results of abdominal CT showed anterior abdominal bulging,abdominal contents prostrated at the base of the abdominal cavity due to gravity,and gas was full of gaps.Abdominal adhesion signs:adhesions of banded fibrous connective tissue established a connection between the base of the abdominal cavity and anterior abdominal wall,and intestinal canals were found inside the adhesions.Parastomal hernia contents of 28 patients had varying degrees of retraction to abdominal cavity,including 9 with complete retraction,13 with a great amount of retraction (retraction volume ＞50％) and 6 with a small amount of retraction (retraction volume ＜50％).Four patients were accompanied by incomplete stoma obstruction,and then obstruction disappeared or relieved after PPP.(2) Surgical and postoperative recovery situations:all the 28 patients underwent successful operations,without intestinal canal injury.Three patients received open parastomal hernia repair,including 2 receiving preperitoneal mesh repair using 8 layers Biodesign meshes (deep venous catheter for local drainage was placed and then removed at postoperative day 2 and 3) and 1 receiving Sugarbaker surgery using PCOPM mesh (peritoneal drainage-tube was placed and then removed at postoperative day 2).Other 25 patients received laparoscopic parastomal hernia repair and Sugarbaker surgery using PCOPM and Sepramesh meshes (no drainage-tube was placed).Bladder pressure of 28 patients at postoperative day 3 was (13±6)cmH2O (1 cmH2O =0.098 kPa),without an abnormal high pressure.Nine patients with postoperative complications were improved by conservative treatment,including 3 with seroma,3 with delayed stoma defecation or incomplete intestinal obstruction,2 with pulmonary infection and 1 with urinary tract infection.There were no occurrences of abdominal compartment syndrome,cardiac failure,lung failure,renal failure,other severe complications and perioperative death.Duration of postoperative hospital stay was (7.2± 1.5) days.(3) Follow-up situations:25 of 28 patients were followed up for 3-25 months,with a median time of 11 months.During follow-up,2 patients had chronic pain around the operation and a sense of discomfort and then were improved by symptomatic treatment,and 1 with parastomal hernia recurrence at postoperative month 6 after open preperitoneal mesh repair underwent again open preperitoneal mesh repair,without recurrence.There were no occurrence of tardive mesh infection and other longterm complications.Conclusion PPP in the treatment of parastomal hernia repair is safe and feasible.

Alcohol-Related Disorders ; metabolism ; Animals ; Benzofurans ; pharmacology ; Glutamic Acid ; metabolism ; Hippocampus ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; metabolism

Animals ; Cyclin-Dependent Kinase 5 ; metabolism ; Ethanol ; adverse effects ; Female ; Hippocampus ; drug effects ; metabolism ; Learning ; drug effects ; Male ; Memory ; drug effects ; Pregnancy ; Prenatal Exposure Delayed Effects ; metabolism ; physiopathology ; Rats

OBJECTIVE Study the role of estrogen receptor (ER)in the inhibition of cell viability and differentiation induced by bisphenol A (BPA)in micro mass culture of rat e mbryonic midbrain(MB) cells.METHODS Micro mass cultures of MB were prepared fro m rat e mbryonic midbrain on gestation day 13.MB cells were exposed to BPA (10 -4 ,10 -6 ,10 -8 ,10 -10 ,10 -12 mol·L -1 )for 5 d.Cell viability was assessed by neutral red uptake test.MB differentiation was detected by he matoxylin staining and i mage analysis.In order to observe the role of ER pathway in the toxicity induced by BPA,cell cultures were co-treated with ICI182780 0.1 n mol·L -1 ,ta moxifen 1 n mol·L -1 and BPA 0.1 mmol·L -1 for 5 d, the cell viability and foci differentiation were detected.Moreover,the protein expression levels of ER in normal e mbryonic brain of gestation day 18,testis tissue fro m adult rats and midbrain cells untreated with BPA were investigated by Western blot.The mRNA expression levels of ER in normal e mbryonic brain of gestation day 13 and gestation day 18,ovary and testis tissue fro m adult rats,and midbrain cells un-treated with BPA were investigated by real-ti me PCR.The mRNA expression levels of Notch1 and Hes1 in MB cells treated with BPA 0.1 mmol·L -1 were also detected by real-ti me PCR.RESULTS BPA 0.1 mmol·L -1 could inhibited MB cell viability and foci differentiation.However,this effect could not be reversed by ER antagonist.The protein and mRNA expression levels of ER in e mbryonic brain and MB cells untreated with BPA were found to be extre mly low.In addition,BPA 0.1 mmol·L -1 could inhibited the mRNA expression levels of Notch1 and Hes1 .CONCLUSION BPA could inhibited MB cell viability and foci differentiation.ER pathway might be not involved in this effect.Instead,Notch-Hes pathway might be involved for this effect.