Objective: To develop price framework of medical service price project and introduce the weights calculation method of the new edition medical service price project. Methods: According to the new instruction manuals of medical service price and the research of the resource costs based on the relative value(RBRVS)of the U.S. Health Care Financing Administration (HCFA) and the American Medical Association ( AMA ) , an analysis framework and dimension of medical service price was raised and authoritative international medical service project price methods w ere summarized. Results: Based on the percentages of constituted factors and the professional features, it found the weights calculation model could be constructed with the weights model, and it could calculate the weights of the elements. Conclusion: Medical service price can be measured and comprehensively researched from the different dimensions of the medical service price, so as to carry out the pricing work of medical service price project and provide better service for pharmaceutical reform.

Objective To investigate the correlation of polymorphism of 8473 (T/C,rs5275) in the 3′-untranslated region of cyclooxygenase-2 (COX-2) gene with bladder cancer. Methods A case-control study on the relation between COX-2 polymorphism and bladder cancer was performed in this study. The Taqman SNP genotyping assay was used to study the COX-2 rs5275 polymorphism. Results The differences in allele or genotype distributions of COX-2 rs5275 between cases and controls (all P < 0.05) were significant. A significantly reduced risk was revealed in bladder cancer patients carrying the TC genotype (adjusted OR =0.178;95%CI:0.119 ~0.264),CC genotype (adjusted OR = 0.087; 95%CI:0.058 ~ 0.129) or (TC/CC) genotype (adjusted OR =0.122;95%CI:0.082~0.181) compared to the control group. Significant difference in genotype distribution of the COX-2 rs5275 site was found associated with sex and smoking (adjusted OR:2.125,0.476;95%CI:1.500 ~3.010,0.325 ~ 0.696);No corelation was found between genetype TT or TC/CC and the pathological features of bladder cancer (P>0.05). Conlusion The separate effect of rs5275 polymorphism of COX-2 is associated with the susceptibility of bladder cancer, the TC/CC genotypes may be a protective factor.

Objective To study the factors affecting the synthesis of 18F-MyoZone,and to evaluate its potential as a myocardial perfusion imaging (MPI) agent in normal Chinese mini-swine.Methods 18F-MyoZone was prepared by substituting the leaving group toluenesulfonyloxy (OTs) from the precursor compound with 18F-fluoride (18F-F-).The conditions affecting the labeling yield were studied by varying the amount of K2CO3 and precursor compound,18F-fluorination reaction time and temperature.PET was performed at 5,30,60 and 120 min post-injection on normal Chinese mini-swine.Results The doses of K2CO3 and precursor,the reaction time and the reaction temperature could affect the labeling yield of 18F-MyoZone,especially K2CO3.The optimized synthetic condition was 1.0 mg K2CO3,2.0 mg mpp2-OTs,20 min reaction time at 90 ℃.The total radio-synthesis time in this condition was 60 min.The uncorrected radiochemical yield was (24.0±5.1) ％.The radiochemical purity was ＞98％.PET imaging showed that 18F-MyoZone had high initial uptake (SUV=8.17± 1.83 at 5 min post-injection) and good retention (SUV =5.78±0.99 at 120 min post-injection) in the heart.The clearance of 18F-MyoZone from liver was very fast.The heart/liver ratios were 3.32,5.31,6.09 and 5.76 at 5,30,60 and 120 min post-injection,respectively.From 5 to 120 min post-injection,the outline of heart was clear and intact.There was almost no interference from the adjacent organs.The quality of PET images was highly satisfactory.Conelusions 18 F-MyoZone has the potential to be a good myocardial perfusion agent.The amount of K2CO3 used could significantly affect the labeling yield of 18F-MyoZone.

Objective To explore appropriate organization and financing models of urban employees supplementary medical insurance under the conditions of the market economy. Methods Employee surveys on willingness to participate in, willingness to pay for, and actual enrolment in supplementary medical insurance were conducted in Shanghai, Wenzhou and Chengdu and nationally different operational models were compared so as to analyze prospectively coverage and operational models of feasible supplementary medical insurance options. Results Characteristics of the employees needs for various supplementary medical insurance options were garnered and appropriate coverage and operational models were put forward. Conclusion It is suggested that the role of the government in the development of supplementary medical insurance be clearly defined, the development of supplementary medical insurance be promoted through policy support and guidance, and the supervision of supplementary medical insurance be strengthened.

Objective To observe the curative effect of sirolimus conversion for liver transplantation patients with chronic renal injury.Methods In 23 recipients of liver transplantation using CNI (19 cases using tacrolimus,and 4 cases using cyclosporine A) with chronic renal injury,the immunosuppressant was converted to sirolimus (SRL).The initial dose of SRL was 4 mg per day and 2 mg at the next day.The blood SRL concentration was determined by using high pressure liquid chromatography.When the valley value of SRL concentration reached a range between 5 to 8μg/L,CNI was withdrawn and MMF (1 g/day) was given simultaneously.The basal values of serum creatinine (Scr),creatinie clearance rate (Ccr) and glomerular filtration rate (GFR) were recorded in the recipients before study,and at 1st,3rd,6th,12th,and 24th month after using SRL,blood SRL concentration,Scr,Ccr and GFR,as well as body weight,blood pressure,blood cells count,liver function (serum bilirubin,albumin and prothrombin time),liver biochemistry (AST,ALT,γ-GT and AKP),blood fat (cholesterol and triglyceride) and urine protein were monitored.At the 12th month after using SRL,the graft liver was biopsied to diagnosis rejection.Results During an average followup period of 29.4 months,there were two deaths.In the remaining 21 cases,the Scr values were (147.40 ± 23.36),(152.60 ± 20.08),(150.20 ± 22.64),( 137.60 ± 18.09) and (138.30 ± 17.04)μmol/L,respectively at 1st,3rd,6th,12th,24th month after using SRL.As compared with basal Scr values [(158.91 ± 29.13) μmol/L],there were statistically significant differences at 1at,12th,24th month (P＜0.05).The Ccr values were (0,97 ± 0.18),(0.99 ± 0.1 4),( 1.00 ± 0.17),(1.07 ±0.29) and (1.14±0.12) ml/s,respectively at 1st,3rd,6th,12th,24th month after using SRL.As compared with basal Ccr value [(0.91 ± 0.14) ml/s],there were statistically significant differences at 1st,12th,24th month (P＜0.05).The GFR values were (0.80 ± 0.15),(0.78 ± 0.11),(0.75 ±0.12),(0.84 ± 0.10) and (0.94 ± 0.13) ml/s,at 1st,3rd,6th,12th,24th month after using SRL.As compared with basal GFR value [(0.71 ± 0.11) ml/s],there were statistically significant differences at 1st,12th,24th month (P＜0.05).The proportion of patients with Scr≤123 μmol/L in 21 cases was 38.1％,33.3 ％,28.6 ％,47.6 ％ and 52.4 ％,respectively at 1 st,12th,24th month (P＜0.05).No rejection cases were observed.Conclusion The immunosuppressant conversion to SRL improves renal function of liver transplantation patients with chronic renal injury,and the conversion cure can not cause rejection.

Objective To approach the effect of telbivudine for preventing recurrence of virus and improving renal function in patients with hepatitis B cirrhosis after liver transplantation with renal insufficiency,and observe the mid-and long-term efficacy.Methods We prospectively researched 17 cases of hepatitis B cirrhosis after liver transplantation with renal insufficiency.Maintenance irnmunosuppression protocol at our centre mainly included calcineurin inhibitor (tacrolimus for 12 cases,and sirolimus for 5 cases).These recipients (n =17) remained under the entecavir (n =10),tenofovir (n =4),lamivudine + adefovir (n =3) for at least 6 months before transformation to telbivudine.We detected HBV-DNA level in serum and ensured no rejection during study,necessarily punctured the graft liver for biopsy to determine if there was rejection.The basal values of blood serum creatinine (Scr) and estimated glomerular filtration rate (eGFR,CKD-EPI formula) were recorded.The Scr and eGFR at 6th month before research and basal values and at 6th and 12th month after telbivudine administration were detected,at the same time the general state and adverse reactions were evaluated.Results During the average follow-up period of 20.2 months,1 patients died.The Ser levels detected in the rest 16 patients were 105.74± 18.24,112.26± 18.67,96.48±22.0 and 89.17± 19.56μμmol/L respectively at 6th month before,basal time and 6th,12th month after telbivudine administration.The eGFR values were 72.56 ± 14.39,66.23 ± 16.61,79.77 ± 20.15 and 83.93 ± 23.67 mL/(minute,m2) at different time points respectively.As compared with the basal value,the Scr and eGFR levels were improved obviously (P＜0.05) at 6th and 12th month after telbivudine administration.The proportion of patients with eGFR ＜60 mL/(min·m2) in 16 cases was 25％,37.5％,12.5％ and 6.3％ respectively at 6th month before,basal time and 6th,12th month after telbivudine administration.The serum creatine phosphokinase level was increased (1 023 IU/L) in 1 patient (6.3％),and decreased after transformation of telbivudine to tenofovir at 3rd month after end of research.No rejection and HBV occurred.Conclusion The telbivudine improves renal function in patients with hepatitis B cirrhosis after liver transplantation with renal insufficiency.Meanwhile,telbivudine prevents hepatitis virus B recurrence.However,large samples of long-term clinical data are needed to further confirm.

Glycerol from oil hydrolysis industry is being considered as one of the abundent raw materials for fermentation industry. In present study, the aerobic and anaerobic metabolism and growth properties on glycerol by Esherichia coli CICIM B0013-070, a D-lactate over-producing strain constructed previously, at different temperatures were investigated, followed by a novel fermentation process, named temperature-switched process, was established for D-lactate production from glycerol. Under the optimal condition, lactate yield was increased from 64.0% to 82.6%. Subsequently, the yield of D-lactate from glycerol was reached up to 88.9% while a thermo-inducible promoter was used to regulate D-lactate dehydrogenase transcription.
Aerobiosis ; Anaerobiosis ; Escherichia coli ; genetics ; metabolism ; Fermentation ; Glycerol ; metabolism ; L-Lactate Dehydrogenase ; metabolism ; Lactic Acid ; biosynthesis ; Promoter Regions, Genetic ; genetics ; Temperature

Curriculum of introduction to clinical medicine(ICM) in the University of Ottawa's Faculty of Medicine was analyzed. Characteristics of ICM course in the University of Ottawa's Faculty of Medicine were: early setting, rich in content, long duration and focusing on clinical. ICM course between Guangxi Medical University and University of Ottawa's Faculty of Medicine were compared. Taking advantages of ICM course in the University of Ottawa's Faculty of Medicine was conductive to better understanding the importance , teaching objectives and means of ICM course . The teaching quality evaluation system of ICM course would be built in the future.

Objective To investigate the biodistribution of 18F-Alfatide II in patients with breast diseases and to compare its uptake with 18F-fluorodeoxyglucose(FDG)uptake.Methods A total of 44 female patients(age:(50.7±8.0)years)with clinically suspected breast cancer from December 2015 to May 2017 were prospectively enrolled and underwent 18 F-Alfatide II and 18F-FDG PET/CT prior to treatment.By drawing regions of interest in normal organs and breast lesions,differences between 18F-Alfatide II uptake and l8F-FDG uptake were evaluated in all patients.Paired t test,two-sample t test and Wilcoxon rank sum test were used for data analysis.Results There were 53 breast lesions confirmed by histopathology in 44 patients.Among them,42 lesions were malignant and the others were benign.The uptake of 18F-Alfatide II was very low in the brain,vocal cords,lungs,blood pool and muscle.But the renal cortex and bladder had high 18F-Alfatide II accumulation.Different levels of 18F-Alfatide II uptake were found in other normal organs including normal breast tissue.There were differences(t values:2.04-41.65,all P<0.05)between 18F-Alfatide II and 18F-FDG maximum standardized uptake value(SUVmax)and mean standardized uptake value(SUVmean)in many normal organs except for the choroid plexus,salivary glands,liver,colon and normal breast tissue.The uptake of 18F-Alfatide II was significantly lower than 18F-FDG in breast cancer lesions(SUVmax:3.77±1.78 vs 7.37±4.48,SUVmean:2.25±0.98 vs 4.54±2,82;t values:4.89,4.82,both P< 0.05),but it was still higher in benign breast lesions(SUVmax:2.37±1.62,SUVmean:1.50±0.92;t val-ues:2.35,2.29,both P<0.05).Also,target/non-target(T/NT)of 18F-Alfatide II in breast cancer lesions was higher than that in benign breast lesions(5.32±3.08 vs 2.60±2.37;t = 2.72,P<0.05).Condusion The biodistribution of 18F-Alfatide II in patients is favorable and 18F-Alfatide II can be clinically used for breast cancer imaging.

Objective To assess the imaging characteristics of 18F-Alfalide II in different tumorbearing mice and pharmacokinetics in Beagle dogs.Methods BALB/c nude mice(n-24)were used for subcutaneous tumor models(A549 and U87MG),orthotopic lung cancer models(A549)and orthotopic breast cancer models(MDA-MB-231)(n=6 in each group).18F-Alfatide II and 18F-fluorodeoxyglucose(FDG)microPET/CT images were compared in the 4 types of tumor-bearing nude mice models.18F-Alfatide II blocking experiment,biodistribution experiment and imaging studies in tumors of different growth cycles were performed in A549 subcutaneous tumor-bearing nude mice models.Pharmacokinetic experiments were carried out in Beagle dogs(n = 6)and CD-1 mice(n = 9).Two-sample t test was used to analyze the data.Results Compared with 18F-FDG,18F-Alfatide II microPET/CT images showed better imaging quality and contrast in subcutaneous A549,U87MG tumors and orthotopic A549(tumor/heart:4.50±1.17 vs 0.95±0.31;t = 4.125,P<0.01),orthotopic MDA-MB-231(tumor/muscle:6.60±1.53 vs 0.92±0.43;t = 3.984,P<0.01)transplantation nude mice models.18F-Alfatide II could specifically target A549 tumors,and the tumor uptake of 18F-Alfatide II was reduced by about 75% after pre-injection with cyclo(Arg-Gly-Asp-D-Tyr-Lys)(c(RGDyk)).18F-Alfatide II was rapidly cleared from the blood of Beagle dogs(T1/2 was(57.34±11.69)min).It was cleared in the form of prototype drug and(69.24±6.82)% of cumulative dose was excreted through the urine within 4 h after administration.Conclusions 18F-Alfatide II shows a higher target/non-target ratio than,18F-FDG in the imaging of A549,MDA-MB-231 and U87MG tumor-bearing nude mice models,which is more conducive to the diagnosis of tumor.18F-Alfatide II has excellent pharmacokinetic properties.