Objective:To analyze the characteristics of health financing at the provincial level according to the total health expenditure since China health system reform began in 2009 and provide evidence for improving health fi-nancing policy. Methods:20 provinces were chosen and vertical and horizontal Comparative approach was used to an-alyze the data. Results:Total health expenditure increased for all regions, of which the biggest rate was Anhui prov-ince, about 82. 97%, while the largest increasing for government health care expenditure was Ningxia province, a-bout 108 . 71%. In 2012 , the provinces with social health expenditure share of total above 40% were allocated in the east region, and the number of provinces with out-of pocket payment share of total above 40% reduces to 5. Conclu-sion:Total health expenditure grew in all regions, but there were differences in the degree that this spending matched the economic level;The financing structure was optimized, but the characteristic of regional financing was different. Some provinces were under huge pressure to reduce out-of pocket payments. Suggestions: Under the premise of im-proving the funding level, financing structure adjustment must be focused, and public funding should play a bigger role and out-of pocket payments should be reduced.

Object: To observe the influence of different combinations of Chinese medicine on rat diabetic index so as to optimize formula. Method: Diabetic rats were induced by high fat food and low dose of streptozotocin, modified uniform design was used to combine different effective fractions, five kinds of combinations were given by intragastric administration for 30 days, glucose, triglyceride, cholesterol, creatinine clearance rate, urinary albumin were detected, the results were analyzed by regression analysis. Results: Glucose, triglyceride, cholesterol, urinary albumin in the five experimental group reduced significantly(P

Objective To study emptying of gallbladder in children with functional dyspepsia(FD),and to investigate correlation of their helicobacter pylori(Hp) status and gallbladder emptying rate.Methods Sixty children with FD were studied,including 30 Hp-ne-(gative) and 30 Hp-positive children.Thirty Hp-positive children received triple eradication therapy 1 week.After 4 weeks,the Hp tests were taken again,27 children became Hp-negative,and the others were still positive eliminated from the study.The difference between the above groups in gallbladder volumes before breakfast and postprandial gallbladder emptying rate were compared.Results The gallbladder volumes before breakfast were bigger and the emptying rate of postprandial gallbladder of children with FD were lower than those of normal controls(P0.05).Conclusions Delayed emptying of gallbladder may cause FD in children.Hp infection isn′t associated with the gallbladder emptying rate.

Objeetive To investigate the effects of fluoride on ultra-structure of thyroid in rats.Methods Eighty SD rats were randomly divided into 4 groups,20 rats in each group.One was control group,the other tree groups were respectively administered 1.19×10-3 mol/L(LF),2.38×10-3 mol/L(MF),and 4.76×10-3 mol/L(HF) of sodium fluoride in drinking water,respectively.The total feeding experiment lasted 1 50 days.Thyroid tissues of rats were collected and ultra-thin sections were made and thyroid ultra-structure wa8 observed under electronic microscope.Results In LF group,nuclear pycnosis and cell vacuolization were observed.In MF group,the electron density decreased,and mitochondria reduced in number.In HF group,some mitochondria were Seen swelling,colloid of thyroid follicles aecumulated,the electronic density in this site increased,microvilli of thyroid endothelial cells decreased significantly,and the amount of lysosome significantly increased.In MF and HF group,organelle disordered,vacuolization in cell endoplasm appeared,membranes of rough endoplasmic reticulum(RER)broke,ribosomes ablated,mitochondria swollen and vacuolated,some cristaes of mitochondria disrupted or disappeared.Conclusion Fluoride can damage the ultra-structure of thyroid,especially the bio-membranes of thyroid cells.

Objective To determine the optimum dose of nalbuphine prepared for patient-controlled intravenous analgesia (PCIA) after caesarean section.Methods A total of 100 parturients,aged 22-40 yr,weighing 60-90 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,at ≥ 37 weeks of gestation,scheduled for elective caesarean section,were divided into 4 groups (n=25 each) using a random number table:sufentanil 2.0 μ,g/kg group (group S),nalbuphine 1.5 mg/kg group (group N1),nalbuphine 2.0 mg/kggroup (group N2,) and nalbuphine2.5 mg/kggroup (group N3).In S,N1,N2 and N3 groups,sufentanil 2.0 μg/kg and nalbuphine 1.5,2.0 and 2.5 mg/kg were added to PCIA solution,respectively,tropisetron 12 mg was added,and PCIA solution was then diluted to 100 ml in normal saline.The PCA pump was set up to deliver a 1 ml bolus dose with a 10-min lockout interval and background infusion at 2 ml/h after a loading dose of 3 ml.Tramadol 50 mg was intravenously injected as a rescue analgesic to maintain visual analogue scale score at rest ≤ 4 or during activity (cough) ≤ 6.The highest Ramsay sedation score,requirement for rescue analgesics,the number of unsuccessfully delivered doses,the number of attempts and occurrence of nausea and vomiting,pruritus and somnolence within 48 h after operation were recorded.Results Compared with group S,the number of unsuccessfully delivered doses,the number of attempts and requirement for rescue analgesics were significantly decreased in N2 and N3 groups,the incidence of somnolence and the highest Ramsay sedation scores were increased in group N3 (P＜0.05),and no significant change was found in the parameters mentioned above in group N1 (P＞ 0.05).Compared with group N1,the number of unsuccessfully delivered doses,the number of attempts and requirement for rescue analgesics were significantly decreased in N2 and N3 groups,and the incidence of somnolence and the highest Ramnsay sedation scores were increased in group N3 (P＜0.05).Compared with group N2,the incidence of somnolence and the highest Ramsay sedation scores were significantly increased (P＜0.05),and no significant difference was found in the number of unsuccessfully delivered doses,the number of attempts or requirement for rescue analgesics in group N3 (P＞0.05).Conclusion The optimum dose of nalbuphine prepared for PCIA after caesarean section is 2.0 mg/kg.

0.05).CART vaccine at 10?g significantly depressed the analgesic effect of morphine analgesia (P

Objective To optimize the extraction process of the compound herba lysimachiae by orthogonal experiment and response surface method. Methods The sum of the peak areas of multiple representative components in the compound herba lysimachiae was used as the evaluation index. The ultrasonic extraction time, ultrasonic temperature and ethanol ratio were analyzed to optimize the extraction process conditions by orthogonal experiment and Box-Behnken response surface analysis method. Results Ultrasonic extraction time and ethanol ratio are important factors in the extraction process of the compound herba lysimachiae. The effect of ultrasonic temperature in the extraction process is not significant. The optimal extraction condition for compound herba lysimachiaeare is 10 min ultrasonic extraction time at 55 ℃ with 55% ethanol. Conclusion The optimal extraction process parameters obtained by combining orthogonal experiment and Box-Behnken response surface method can be used for the extraction of representative components from the compound herba lysimachiae and pharmaceutical research in the future.

Objective To investigate the effects of different concentrations of sodium fluoride on the morphologic characteristics of primarily cultured thyroid cells of SD rats and in order to obtain important proof for approaehing the mechani8m of thyroid gland damage caused by fluoride.Methods Thyroid cells of SD rat were primarily culture for 96 hours,and cell density was adjusted to 5.0×108/L Cell suspension with 5 ml Wills seeded into 6 weII plates,after 12 hours,0(contr01),10.100,1000 μmol/L of sodium fluoride was added into the well, witll each well representing different level of treatment group.Finally the cultured thyroid cells were collected for morph010gic study.Results Under microscope,the transparency of the control thyroid cells Was good,and cells gathered in cluster and adhered to wall.But a lot of cells treated with fluoride suspended,and lost their transparency-under scaning delectron microscope,the control calls showed integrated membrane and tightness to each other,as well as clear boundary between cells normal proliferation.While the thyroid cells treated with 10,100 μmol/L sodium fluoride 0bviouslv shrinked and deformed,and the cells treated with 1000 μmol/L of sodium fluoride were broken-Conclusions nuoride can affect the growth and development of thyroid cell and damage the structure and morphology.Sodium fluoride affects the morphologie characteristics of thyroid cells in a dose-response manner.

BACKGROUNDNeurofibromatosis type 1 (NF1) is the most common genetic syndrome predisposing patients to various tumors due to dysregulation of the Ras signaling pathway. Recent research has shown NF1 patients also suffer a spectrum of bone pathologies. The pathogenesis of NF1 bone diseases is largely unknown. There is no current treatment. By Nf1 heterozygote (Nf1+/-) mice and Nf1 conditional knockout mice, we and other groups demonstrated abnormal osteoblast and osteoclast function due to dysregulation of Ras signaling. However, the specific downstream effector pathways linked to NF1 abnormal osteoblastogenesis and osteoclastogenesis have not been defined. In this study, we investigated the Ras downstream effector related with NF1 bone disease.

METHODSWe used Nf1+/+ and Nf1+/- mice as normal and NF1 models. Bone stromal cells extracted from Nf1+/+ and Nf1+/- mice were induced osteoclasts. The osteoclast cell was stained by tartrate resistant acid phosphatase staining. The osteoclast cell number was counted and the surface area of osteoclast cells was calculated under the microscope. The mRNA of mammalian target of rapamycin (mTOR) was determined by quantitative reverse-transcription-polymerase chain reaction. The presence of ribosomal protein S6 kinase was determined by Western blotting.

RESULTSCompared with Nf1+/+ mice, Nf1+/- mice had about 20% more of osteoclast cells. These osteoclast cells were larger in size with more nuclei. Hyperactive mTOR was detected in Nf1+/- osteoclast cells. Inhibition of mTOR signaling by rapamycin in Nf1+/- osteoclasts abrogated abnormalities in cellular size and number.

CONCLUSIONmTOR pathway inhibition may represent a viable therapy for NF1 bone diseases.

Animals ; Male ; Mice ; Neurofibromatosis 1 ; drug therapy ; Osteoclasts ; drug effects ; physiology ; Osteogenesis ; drug effects ; Sirolimus ; pharmacology ; TOR Serine-Threonine Kinases ; antagonists & inhibitors ; physiology

BACKGROUND: Glucocorticoid-induced osteoporosis has relationship with the down-regulation of osteoprotegedn expression. Osteoprotegerin could inhibit bone resorption in the animal experiment and clinical application for treating oestrogenic hormone deficiency osteoporosis. OBJECTIVE: To investigate the effects of exogenous recombinant osteoprotegerin fusion protein on glucocorticoid-induced osteoporosis in rats. DESIGN, TIME AND SETTING: Randomized grouping, controlled animal expenment was performed in the Institute of Orthopedics, Chinese PLA General Hospital between January 2006 and June 2008. MATERIALS: Sixty healthy male Wistar rats of clean grade; Dexamethasone was produced by Tianjin Jinyao Amino Acid Co., Ltd (Licenca No. H12020515). METHODS: Sixty rats were divided into 3 groups randomly with 20 rats in each. Control group: the rats were administrated with 0.9％ sodium chloride. Dexamethasone group: the rats were administrated with dexamethasone intramuscularly. Osteoprotegedn group: the rats were administrated with dexamethasone and recombinant osteoprotegerin intramuscularly. MAIN OUTCOME MEASURES: All rats were sacrificed at 12 weeks after administration. The urine calcium, phosphor, creatinine, bone mineral density, biomechanics tests of femur and vertebral body, were measured. Immunohistochemistry staining were performed to observe osteoprotegerin expression.RESULTS: Sixty rats were all involved in the final analysis. ①Compared with control group, udne calcium increased in the Dexamethasone group (P < 0.05); the bone mineral density of lumbar vertebra and femur decreased significantly (P < 0.05), especially lumbar vertebra (P < 0.01); biomechanics tests of femur and vertebral body (maximum load, maximum stress, elasticity load, elasticity stress, elastic modulus) decreased significantly (P < 0.05); immunohistochemistry staining showed that endogenous osteoprotegerin expressions were reduced significantly in bone marrow of Dexamethasone group (P < 0.01). ②Compared with Dexamethasone group, urine calcium decreased in the osteoprotegerin group (P < 0.01 ); the bone mineral density of lumbar vertebra and femur increased (P < 0.05); the parameters of biomechanics testa of femur and vertebral body increased (P < 0.05); the osteoprotegerin expression was not changed between Dexamethasone group and osteoprotegerin group.CONCLUSION: Glucocorticoid could inhibit osteoprotegerin expression in the bone followed by progressive bone loss and induce osteoporosis. Recombinant osteoprotegerin works effectively in inhibiting bone resorption after administrated with glucocorticoid, reduce bone resorption index, increase bone mineral index and bone strength, thus improving the osteoporosis which is induced by glucocorticoid.