Given the significant improvement in terms of its coverage and compensation depth,China's basic medical insurance system has inherent setbacks in its structure as held by the authors.They hold that the medical insurance as the most important source of compensation for medical institutions,should further reform its structure of financing and reasonably raise the percentage of compensation; adjust the time reference and space reference for prepayment estimation such as the total prepaid amount; deepen supportive reforms for the payment manner.All these measures aim at minimizing impact of the payment control mechanism on routine medical activities and exploring diversified payment manners that are feasible.

Objective To investigate the abnormal expressions of light chain immunoglobulins kappa (Ig?) and lambda ( Ig?) in multiple primary malignant tumors (MPMT) in elderly patients. Methods The expressions of Ig? and Ig? in specimens obtained from multiple malignant tumors in 21 elderly patients were investigated. Immunohistochemical staining was performed with mouse antihuman Ig? and Ig? monoclonal antibodies. Among 21 patients with multiple primary malignant tumors, the first tumor which occurred in the digestive tract was detected in 20 patients. In 17 patients first and second tumors were found to occur in the digestive tract. In 21 patients with MPMT the relationship between the expressions of light chain immunogloblin and survival time was analyzed. Results Positive staining of Ig? and/or Ig? in specimens from the first and/or second tumor tissues was found in 16 patients(76 2%). Statistic analysis showed that there was close relationship between the expression of Ig? and that of Ig? in the tissues from double tumors ( P

The aim of this study is to explore the anti-HSV activity of P.vulgaris polysaccharides and gels in vitro and in vivo with the provision of scientific evidence for the further research of anti-HSV new drugs.Plaque reduction assay was adopted to determine the IC50 value of P.vulgaris polysaccharides on HSV-1 and HSV-2 in vitro.In addition,HSV-1 (skin) and HSV-2 (vulva) infected guinea-pig models were established for assessing the anti-HSV activity of polysaccharides and gels in vivo,and infected lesion degree,number of papulovesicle,typical lesion score and the DNA copy numbers of HSV-1 and HSV-2 viruses in the lesion tissue were taken as the indexes.It was found that the activities of HSV1 and HSV-2 viruses was inhibited by P.vulgaris polysaccharides in vitro,while HSV induced skin lesions in the guineapigs were ameliorated by P.vulgaris gel,exerting an anti-HSV action.In conclusion,it was demonstrated that P.vulgaris polysaccharides and gels performed an anti-HSV action both in vitro and in vivo with the hidden value of developing antiHSV agents.

Objective To understand the regional distribution and drug resistance of clinical isolates of bacteria flora ,in order to provide the basis for the diagnosis and treatment of bacterial infection .Methods According to the national clinical test proce‐dures operation separation strains ,HX‐21 bacteria identification/susceptibility analyzer bacteria identification and drug sensitive test .Results Among 1 705 strains of isolated bacteria ,Gram‐positive cocci accounted for 39 .8% ,Gram‐negative bacteria accounted for 60 .2% ;separation rate from high to low were:benzene azole resistance westwood 13 .3% coagulase negative staphylococcus , pseudomonas aeruginosa ,12 .0% benzene azole resistance westwood staphylococcus aureus 11 .3% ,did not produce the ultra broad spectrum beta lactamase 10 .7% ,e .coli to produce ultra broad spectrum beta‐lactamase e .coli 9 .9% ,acinetobacter was 7 .1% ,pro‐ducing ultra broad spectrum beta‐lactamase pneumonia klebsiella bacteria 5 .9% ,did not produce the ultra broad spectrum beta‐lac‐tamase pneumonia klebsiella bacteria 5 .7% ,benzene azole westwood sensitive coagulase negative staphylococcus 4 .8% ,enterococ‐cus was 4 .8% ,benzene azole westwood sensitive staphylococcus aureus 4 .5% ,etc .Conclusion The common pathogenic bacteria is gram‐negative bacilli in the common pathogenic bacteria .In negative bacilli infection ,acinetobacter ,pseudomonas aeruginosa ,e .coli , klebsiella pneumoniae ,etc were more common .In staphylococcus aureus strains ,benzene azole westwood drug‐resistant strain ratio is higher than benzene azole westwood sensitive strain rate for 3 times .In addition to the vancomycin and teicoplanin sensitive ,other commonly used antibiotics shows different degrees of resistance .

Objective To evaluate the capability of virtual non-contrast (VNC)of the second-generation dual-source CT (DSCT), and to display the adipose tissue of gastric serosa.Methods 48 patients with gastric cancer undergoing preoperative DSCT and sur-gery were enrolled.The true non-contrast (TNC)values and VNC values of perigastric adipose tissue were measured and compared with conventional non-contrast scanning and VNC of arterial phase and venous phase.The VNC values of perigastric adipose tissue were compared between serosal involvement group and non-serosal involvement group.Results There was statistical difference be-tween TNC values and VNC values of perigastric adipose tissue (P <0.05),the absolute differences were under 13 HU.The differ-ence of VNC values between serosal involvement group and non-serosal involvement group was significant (P <0.05).Conclusion VNC of the second-generation DSCT can clearly display the adipose tissue of gastric serosa.It has certain capability in judging sero-sal involvement.VNC has the proficiency to replace conventional non-contrast scanning.

Objective To investigate the diagnostic value of plasma cardiac troponin Ⅰ (cTnI) and brain natriuretic peptide (BNP) for heart failure complicated with pneumonia in children.Methods 30 children of heart failure complicated with pneumonia (heart failure group),30 children with pneumonia in acute phase (pneumonia group) and 30 healthy children (control group) were selected.The levels of plasma cTnI and BNP in the heart failure group were detected in acute phase(6-24h) and recovery phase(5-7d),and the results were compared with pneumonia group and control group.Results The levels of plasma cTnI and BNP in the heart failure group were significantly higher than those in the pneumonia group and control group(F =5.303,4.632,all P ＜ 0.05).The levels of plasma cTnI and BNP were not significantly different between the pneumonia group and control group(P ＞ 0.05).The levels of plasma cTnI and BNP in recovery phase of the heart failure group were significantly lower than those in acute phase of the heart failure group (t =4.291,5.393,all P ＜ 0.05),but there were no siganificant differences compared with the pneumonia group and control group(P ＞ 0.05).Conclusion The plasma cTnI and BNP maybe a reliable index in the diagnosis of heart failure complicated with pneumonia in children.

Objective To evaluate the performance of ACL TOP coagulation analyzer system in the laboratory of children′s hospital. Methods According to the documents of CLSI, the analytic characteristics including precision, accuracy, linearity, interference and carryover rate were examined; specimens from healthy children were collected and assayed to determine the reference range of Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Thrombin Time (TT), Fibrinogen (FIB) and D-Dimer (D-D) from children on ACL TOP. Results The within-run and between-day coefficient of variability (CV) were within an acceptable range; The accuracy deviation of PT , APTT and FIB were less than 1/2 allowed total errors; The results of determination of FIB linearity test were correlated with the results of calculation: Y = 1.002 1X-0.122, R2 =0.998 2; The extent of influence of low to middle grade of jaundice , fat and hemolysis on each test were all less than 1/2 allowed total error; The carryover rates were lower than 1.81% and within an acceptable range; The reference range of PT, APTT, TT and FIB were PT (9.1-13.1 s), APTT (24.9-42.1 s), TT (12.6-21.1 s), FIB (1.924-4.011 g/L). Conclusion The ACL TOP coagulation analyzer has good repeatability, stability, linearity and capability of anti-interference and anti-carryover.

BACKGROUND: Having breakfast everyday is a behavior promoting health recommended WHO, while it is easy to be ignored.OBJECTIVE: To investigate the breakfast habits of pupils in Beijing and Shanghai so as to provide a scientific basis for further studying the problems in having breakfast among the pupils, drafting and developing "nutritious breakfast program for students".DESIGN: Stratified and cluster sampling and investigation study were used based on the pupils.SETTING: Institute of health for child of two universities.SUBJECTS: A total of 8688 six to eleven years old Beijing and Shanghai pupils were involved from March 2002 to June 2002. Among them 4692 pupils came from Beijing. There were 4637 valid questionnaires, 2386 of which were from male pupils and 2251 from female pupiIs. Among the total subjects, there were 4300 Shanghai pupils, and 4051 questionnaires were valid, of which 2031 were from the male pupils and 2020 from female students.METHODS: A self-administered questionnaire survey was conducted. The content of the questionnaire included the general conditions of the family, dietary preferences, food for breakfast, consumption of the milk food and so on.RESULTS: The results showed that about 25.8% boys and 21.6% girls in Beijing did not eat breakfast regularly; similarly, the percentage was about 11.4% for boys and 13.3% for girls in Shanghai. The reasons for not having breakfast included the following: They had no appetite, or had no enough time for it, or the parents were too busy to prepare in the mornings. For those of them who eat breakfasts, the nutrients of their breakfast usually were not adequate. 55% of the students had their breakfast prepared by their mothers. As for the eating sites, students mainly ate at home; the next was having it on the way to school or eating at the roadside luncheonettes. The cost of breakfast was 2 - 3 yuan. The breakfast behaviors of the pupils were closely related with the behaviors of their mothers( r = 0. 4333, P < 0.01 ).CONCLUSION: It is suggested that quality of breakfast of the pupils need to be improved. The behaviors of the parents influence their children in breakfast habits.

Objective:In investigate the status quo of current physician-patient relationship.Method:A self-designed questionnaire is conducted among the medical staff and patients in 40 hospitals(20 grade 3 hospitals and 20 grade 2 hospitals) located in 10 cities of China.Result:9.3% of the total patient responders consider the current physician-patient relationship dissatisfying,with a counterpart ratio of 31.2% in responders of medical staff.Conclusion:Currently in China,main-stream of physician-patient relationship is harmonious,but it can not be denied that medical staff are suffering tremendous stress from the ever tenser physician-patient contradictions.

Objective To measure the estrogen concentration of estrogen (E 2) in the culture medium of rat astrocytes (ASTs). Methods Astrocytes in brain cortex of the 2-day-old neonatal rats were collected and cultured. The number of astrocytes was counted and the concentration of estrogen was measured by ELISA method at 0, 7, 14, and 21 d after culture. Results The cell counts were 1?10 4/ml, 1.1?10 6/ml, 1.4?10 6/ ml, and 1.5?10 6/ml, respectively. The concentrations of E 2 were: 0 pg/ml, (117.03?21.32) pg/ml, (266.91?22.03) pg/ml, and (252.62?27.99) pg/ml, respectively. No estrogen was detected in the primary culture medium. The concentration of estrogen increased in a time-dependent manner and reached the peak at 14 d, and then decreased gradually but remained at a certain level. Conclusion E 2 is secreted by astrocytes in the brain cortex of the 2-day-old neonatal rats.