To a certain extent, itemized government subsidies to public hospitals, primarily used for hospital infra-structure and large equipment investments, can alleviate the financial pressure of development expenditures and thus re-duce the medical expenditure burden on patients. To test the hypothesis, the panel data method has been adopted based on the data of 23 tertiary hospitals. Empirical results find that:(1) increases in itemized subsidies will reduce the burden of medical expenses on patients;(2) conversely, the impact of itemized subsidies on outpatient medical expenses is more sig-nificant. By sharing a portion of public hospital expenses and impacting hospital service providing behavior, itemized sub-sidies help to reduce the burden of medical expenses on patients.

OBJECTIVETo observe the clinical effect of Shugan Yiyang Capsules combined with sertraline in the treatment of premature ejaculation (PE).

METHODSWe randomly assigned 192 PE patients to receive sertraline hydrochloride 50 mg qd (control group, n = 96) or sertraline hydrochloride 50 mg qd plus Shugan Yiyang Capsules at the dose of 4 capsules tid ( combination therapy group, n = 96) , both for 6 weeks. We compared the intravaginal ejaculatory latency time (IELT) and Chinese Index of Premature Ejaculation ( CIPE) scores between the two groups of patients before and after medication and at 6 weeks after drug withdrawal.

RESULTSCompared with the baseline, the IELT was significantly increased after 6 weeks of medication in the combination therapy group ([1.41 ± 0.53] vs [6.69 ± 3.56] min, P < 0.05) and the control group ([1.43 ± 0.48] vs [5.37 ± 2.91] min, P < 0.05), and so was the CIPE score in the former (9. 80 ± 2.06 vs 21.62 ± 4.76, P < 0.05) and the latter group ([9.41 ± 1.97] vs [20.85 ± 4.83] , P < 0.05). In comparison with the pre-medication indexes, the IELT ([3.77 ± 1.63] min) and CIPE score (16.92 ± 3.37) of the combined therapy group were remarkably improved at 6 weeks after drug withdrawal (P < 0.05), but not those of the control ([1.19 ± 1.34] min and 10.59 ± 2.38, P > 0.05).

CONCLUSIONShugan Yiyang Capsules combined with sertraline have a definite and lasting effect on premature ejaculation.

Capsules ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Premature Ejaculation ; drug therapy ; Sertraline ; therapeutic use

Acupuncture Therapy ; Female ; Humans ; Middle Aged ; Thalamic Diseases ; therapy

ObjectiveTo observe the effect of muscle stimulating instrument on patients with spasticity of lower limbs after surgical treatment.Methods49 adults with spasticity of lower limbs after surgical treatment were divided into the treatment group (21 cases) and the control group (28 cases). Patients of two groups were treated with routien rehabilitation training, but muscle stimulating instruments treatment was added to patients of the treatment group. The muscle strength and motor ability of patients of two groups were followed up and compared.ResultsThe muscle strength and motor ability of the treatment group were better than that of the control group during follow-up period (P<0.05,P<0.01).ConclusionMuscle stimulating instrument can accelerate the recovery of muscle strength and motor ability in adults with spasticity of lower limbs after surgical treatment.

Objective: To investigate the prevalence and influencing factors of caries among Tibetan primary school students in Maqu County, Gansu Province, so as to provide insights into caries control among children living in ethnic minority areas. Methods: Tibetan primary school students at grades three to six were sampled from two primary schools in Maqu County using a multi-stage cluster sampling method. Primary school students' demographics, dietary habits and oral health habits were collected using questionnaire surveys, and the caries was tested. Factors affecting the development of caries were identified using a multivariable Poisson regression model. Results: A total of 378 Tibetan primary school students were tested, and there were 334 students with caries, with a caries prevalence rate of 86.30%, and a mean caries number of (4.72±2.69) teeth. Multivariable Poisson regression analysis showed that grade (grade 5, IRR=0.791, 95%CI: 0.706-0.886; grade 6, IRR=0.698, 95%CI: 0.593-0.822), frequency of vegetable intake (less than once daily, IRR=0.872, 95%CI: 0.778-0.978; once daily, IRR=0.769, 95%CI: 0.677-0.873; twice and more daily, IRR=0.571, 95%CI: 0.469-0.696), frequency of tooth brushing (once daily, IRR=0.814, 95%CI: 0.734-0.904; twice and more daily, IRR=0.606, 95%CI: 0.521-0.703) and frequency of oral examinations (IRR=0.736, 95%CI: 0.594-0.911) were influencing factors of caries. Conclusion The prevalence of caries is 86.30% among Tibetan primary school students at grades 3 to 6 in Maqu County, and age, dietary habit and oral health habit are factors affecting the development of caries.

97 cases of jaw bone fractures were treated with rigid internal fixation.16 cases had malocclusion postoperation.The etiology was analyzed and the prevention methods were proposed.Intermaxillary elastic traction or fixation and craniomaxillofacial fixation or craniomentum elastic traction were performed to treat the malocclusion.By this way,14 cases were cured.1 case was operated again to resume the normal occlusion,1 case received occlusal adjustment.Incomplete reduction,incorrect operative performance,deficiency of postoperative intermaxillary fixation and incorrect intermaxillary fixation were the main causes to malocclusion.So anatomic in time reduction,correct operative performance,intermaxillary fixation,application of craniomaxillofacial fixation or craniomentum elastic traction instead of intermaxillary fixation for some special cases are effective methods to correct postoperative malocclusion.

BACKGROUND:Pulsed laser deposition synthesis technology has been used to prepare new nano-hydroxyapatite thin film coating by colagen deposition on artificial mechanical heart valve. OBJECTIVE: To investigate the toxicity of new nano-hydroxyapatite thin film on human umbilical vein endothelial cels. METHODS: Human umbilical vein endothelial cels were cultured with nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene and phenol solution. Within 72 hours, cel growth was observed under the inverted phase contrast microscope. At 7 days after culture, cel proliferation and toxicity grading were detected using Cel Counting Kit-8. RESULTS AND CONCLUSION:At 24 hours after culture, cels grew wel, showed fusiform shape, and had strongrefraction in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene groups, and no significant differences in cel morphology and number were detected among above groups. Cels in the phenol solution group were suspended, round, pyknotic and dead. At 48 hours, except phenol solution group, cel number increased significantly, and cel grew densely in other three groups. At 72 hours, cels grew strongly, and the gap became smal obviously. Within 7 days after culture, cel proliferation activity was not significant in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, and high-density polyethylene groups, which was significantly higher than in the phenol solution group (P < 0.05). The toxicity of nano-hydroxyapatite film graded 0 to 1. These results suggested that nano-hydroxyapatite artificial mechanical heart valve has good histocompatibility, but no toxicity.

BACKGROUND:A new type of nano-hydroxyapatite artificial mechanical heart valve has been developed using pulsed laser deposition technology at the Department of Materials, Hefei University and Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, China. OBJECTIVE:To investigate the compatibility of nano-hydroxyapatite artificial mechanical heart valve with human umbilical vein endothelial cels. METHODS:Human umbilical vein endothelial cels were in vitroisolated, cultured and passaged to the 2-4 generations, and then the cel suspension was inoculated onto the nano-hydroxyapatite artificial mechanical heart valve. After 3, 7, 12 days of culture, the cel growth on the artificial mechanical heart valve was observed under scanning electron microscope. In addition, the human umbilical vein endothelial cels were respectively cultured in room-temperature and high-temperature extract liquids of nano-hydroxyapatite artificial mechanical heart valve, high-density polyethylene and phenol solution extracts for 72 hours, and then, the proliferation of cels was detected by MTT method. RESULTS AND CONCLUSION:Under the scanning electron microscope, the human umbilical vein endothelial cels were fusiform- or polygon-shaped with protuberances adhered to the artificial mechanical heart value at 3 days of culture; the cels were stretched thoroughly and fused at 7 days of culture; and the cels were confluent to pieces that tightly overlaid the heart valve surface and the extracelular matrix was formed localy at 21 days of culture. Results from MTT test displayed that the nano-hydroxyapatite artificial mechanical heart valve had no cytotoxicity to the human umbilical vein endothelial cels, indicating a good cytocompatibility.

Objective To investigate the effect of Suanzaoren Decoction on hippocampus, cortex BDNF and TrKB gene expression in depression model rats. Methods Depression rat models were established by social-isolated raise and chronic stress stimulation. Suanzaoren decoction was administrated to the models. RT-PCR was adopted to detect the expression of mRNA BDNF and TrKB genes. Results The mRNA expression of BDNF and TrKB in cortex of Suanzaoren decoction high dose group、medium dose group and clomipramine group(0.213±0.094, 0.639±0.023, 1.032±0.015, 1.089±0.014, 1.580±0.012, 1.860±0.019)were all higher than the model group(0.032±0.008, 0.001±0.000), showing a significant difference among four groups (P<0.01), and the mRNA expression of BDNF and TrKB in hippocampus of Suanzaoren decoction high dose group, medium dose group and clomipramine group(0.213±0.094, 0.639±0.023, 1.032±0.015, 1.089±0.014, 1.580± 0.012, 1.860±0.019)were higher than the model group (0.021±0.015, 0.125±0.013), there was a significant difference between four groups(P<0.01). Compared with the model group, the mRNA expression of low-dose group of Suanzaoren decoction in both cortex and hippocampus of BDNF and TrKB was not significantly different to the model group(P>0.05). Conclusion Suanzaoren decoction can increase the expression of BDNF and TrKB gene, promote neuronal proliferation, and resist depression.

Long-term treatment with an agonist of peroxisome proliferator-activated receptor (PPAR)-γ is associated with bone fractures in the clinical practice. However, the mechanisms underlying the fractures are not fully understood. This study was aimed to examine the effect of rosiglitazone (an agonist of PPAR-γ) of different doses on the proliferation, differentiation, and transforming growth factor beta 1 (TGF-β1)-induced expression of connective tissue growth factor (CTGF) in primary rat osteoblasts in vitro. Osteoblasts were isolated from newly born SD rats and treated with different doses of rosiglitazone (0-20 μmol/L). The proliferation and differentiation of osteoblasts were measured by MTT assay and NPP assay, respectively. The expression of CTGF was determined by RT-PCR and Western blotting. The results showed that most isolated osteoblasts displayed strong alkaline phosphatase (ALP) activity and treatment with different doses of rosiglitazone did not affect their proliferation, but significantly inhibited the differentiation of osteoblasts in a dose-dependent manner. Moreover, treatment with different doses of rosiglitazone significantly reduced the TGF-β1-induced CTGF mRNA transcription and protein expression in a dose-dependent manner in rat osteoblasts. It was concluded that the activation of PPAR-γ may inhibit the differentiation of osteoblasts by reducing the TGF-β1-induced CTGF expression in vitro.