OBJECTIVE:To study the implementation of scoring diseases payment under the control of total budget in some ar-eas of China,and provide reference for the further improvement of the payment. METHODS:Based on the operation process of scoring disease payment in the control of toal budget,the specific practices of Huaian,Nanchang,Zhongshan and Taiwan area, were compared. RESULTS:It showed differences in the control and allocation of total budget,the establishment of scoring diseas-es,the setup of adjustment coefficient,the development of balance methods,the complementary mechanism and the monitor exami-nation setting. CONCLUSIONS:Whether to classify the diseases according to diagnosis and treatment methods,how to setup ad-justment coefficient appropriately,how to reimburse the patients in stages and how to strengthen supervision are worthy of further thinking and exploring.

Medicine, Chinese Traditional ; methods ; trends

Coronary Disease ; diagnosis ; Humans ; Medicine, Chinese Traditional ; methods

BACKGROUND:Tissue engineering requires a lot of seed cells. Osteoblasts have become important seed cells in bone tissue engineering. However, it is difficult to culture the osteoblasts, and cellnumber, purity, proliferation and differentiation activity are different obtained by different culture methods. OBJECTIVE:To identify and compare three common primary osteoblat culture methods, and to explore a method for the primary culture of osteoblasts which is easy to operate, economical and effective, in order to provide basis for the further experimental research. METHODS:Calvarias were dissected from newborn Sprague Dawley rats in 72 hours, and osteoblasts were isolated with col agenase digestion method, sequential digestion method and bone tissue method respectively. The morphological observation and cytochemical staining were performed, the growth curve of the cells was drawn with cellCounting Kit-8 method, and the rate of living osteobalsts was counted with trypan blue staining. RESULTS AND CONCLUSION:The proliferation of the insolated and cultured osteoblasts was wel with typical characteristics of osteoblasts, cytochemical staining results were positive. Compared with the sequential col agenase digestion method, the col agenase digestion method presented higher production of osteoblasts and higher cellsurvival rate (P<0.05), and the col agenase digestion method was easier than the sequential col agenase digestion method and cost less than sequential col agenase digestion method. Bone tissue method was the easiest method with less damage to cells, but bone tissue method presented lower production of osteoblasts and cost much more time, which cannot be used in large-scale osteoblast culture. The col agenase digestion method is a simple, efficient and ideal method for isolation and culture of primary osteoblasts.

The RD-1 locus has been considered crucial in the pathogenesis of M.tuberculosis, the RD-1 locus is 9.5 kb and spanning open reading frames Rv3871 to Rv3879c encoding 9 different proteins separately.The RD-1 locus is missing in all bacillus Calmette-Guerin(BCG) strains, and is one of the key virulence factor in M.tuberculosis.The RD-1 locus participates in a new secreting system named ESX-1, which can facilitate the secretion of some special proteins.The two important proteins encoded by the RD-1 locus named CFP-10 and ESAT-6 can form a tight 1∶1 complex, and has been shown to be coordinately secreted and lead to a strong T cell response, which suggests that these two proteins may act as ideal target antigens in diagnosis and prevention of tuberculosis(TB).

Objective To study the protective effect of total glucosides of Mudan cortex(TGM) on acute myocardial ischemia in mice and its mechanism. Methods The total of 60 mice were randomly divided into 5 groups (n = 12),normal control and model control (were given equal capacity of 0.9% sodium chloride solution),and TGM at low,middle,high dose (were given with 50,100,200 mg?kg-1 TGM).The mice were administered once daily for consecutive seven days.After the last administration,the mice in the model control and drug groups were treated by intraperitoneal injection of 15 mg ? kg-1 isoproterenol to to make myocardial ischemia animal model. TGM on the T wave and J point on ECG, and serum lactate dehydrogenase (LDH),myocardial tissue superoxide dismutase (SOD),malondialdehyde (MDA) changes was detected,and the extent of myocardial ischemic injury in mice was measured by Nagar-Olsen staining. Results TGM significantly reduced the displacement of ECG T wave and J point,and improved the related biochemical indexes in mice with myocardial ischemia.The activity of LDH [(898.992± 285.108) μmol?mg-1 ] ,the content of MDA [(11.737 ±5.162) nmol?mg-1 ]in mice treated with TGM at high dose obviously decreased in comparison to the model controls,and the activity of myocardial SOD [(45. 505 ± 20.711) U?mg-1 ] significantly elevated compared with the model control.It was showed that TGM significantly diminished the areas of cardiac muscles ischemia injured via Nagar-Olsen staining. Conclusion TGM has the remarkable protective effect on acute myocardial ischemia injury in mice.

BACKGROUND: The oriented migration of bone marrow mesenchymal stem cells may depend on the interaction between local chemotactic factors and cellsurface receptors. However, which chemotactic factors may mediate the oriented migration of bone marrow mesenchymal stem cells towards the fracture site remains unclear. OBJECTIVE: To tag autologous bone marrow mesenchymal stem cells, evaluate its role in bone healing, and detect the highly expressed factors associated with migration of bone marrow mesenchymal stem cells in the microenvironment. METHODS: The fluorescence/chimeric C57BL/6 mouse models were established, then left shankbone fracture models were also produced. The percentages of green fluorescent protein positive cells to al cells at the fracture site and the percentage of osteoblasts differentiated from bone marrow mesenchymal stem cells to al the osteoblasts were detected at different time points. The role of bone marrow mesenchymal stem cells in the fracture repairing was evaluated. The levels of chemotactic factors protein expression at the fracture site in different time points were detected with immunohistochemistry technology. RESULTS AND CONCLUSION: The percentage of green fluorescent protein positive cells to al cells at the fracture site was (3.011±0.911)%, (9.031±0.145)%, (12.064±0.145)% at 1, 5, 14 days postoperatively; and osteoblasts differentiated from bone marrow mesenchymal stem cells accounted for 50% of al the osteoblasts. After fracture, the stromal cel derived factor-1, colony stimulating factor, hepatocyte growth factor, monocyte chemoattractant protein-1, and matrix metal oproteinases-9 were expressed to varying degrees in the microenvironment, while the expression of granulocyte colony-stimulating factor was negative. The expression of stromal cel derived factor-1 in the fracture microenvironment was the highest, mainly due to the migration of bone marrow mesenchymal stem cells. Experimental findings indicate that, autologous bone marrow mesenchymal stem cells participate in and play an important role in bone healing. The stromal cel derived factor-1 plays an important role in promoting bone marrow mesenchymal stem cells migration and promoting bone healing.

AIM To study the analgesic effects of melatonin (MT) and related mechanisms. METHODS The threshold was measured by hot plate test.? endorphine (? EP) was determined by radioimmunoassay (RIA). RESULTS MT (40～160 mg?kg -1 , ip) had significant dose and time dependent analgesic effects in hot plate test. The analgesia was also induced by injection (icv) of MT (0 25 mg?kg -1 ). The day night rhythm of pain threshold was not observed in 7 d after pinealectomy, but it appeared in sham operated rats.? EP content of rat brain measured by RIA indicated that the level of ? EP in hypothalamus and pituitary decreased significantly 1 h after ip MT(100 mg?kg -1 ). The analgesic effect of MT was attenuated by pretreatment of reserpine (3 mg?kg -1 ip) or ? receptor blocker phentolamine (100 mg?kg -1 , sc). CaCl 2 (230 mg?kg -1 ) antagonized the analgesic effect of MT, and EGTA and verapamil significantly enhanced the analgesia of MT in the same situation. CONCLUSION MT has significant analgesic action which may be related to opiate system, adrenergic system, and Ca 2+ content.

Objective:The objective of this study was to evaluate the relationship between the adequacy of nutritional therapy and prognosis in trauma patients.Methods:217 trauma patients were included.The nutritional therapy interventions were divided into three groups:low energy therapy (＜50％),moderate energy therapy (50％ ～ 80％),high energy therapy (＞ 80％).General data,hospitalstay,ICU stay,infectious complications and mortality were compared among groups.Results:The protein intake of high energy group was higher than the other two groups (P ＜0.01).High energy therapy was associated with reduced mortality and decreased length of hospital stay.Kaplan-Meier survival analysis indicated that high energy therapy had a significantly higher 60 days cumulative survival rate compared with other groups.Conclusion:High energy therapy is more effective and associated with improved mortality and decreased length of stay.

Updated guidelines on the management of non-Hodgkin lymphoma (2015.V2) have been issued by the National Comprehensive Cancer Network (NCCN) in March 3, 2015.The Castleman disease (CD) is included for the first time.References from relevant publications, the standards for diagnosis and treatment of CD are described in detail and it also provides professional healthcare with clear guidance on the management of patients with CD.