Objective:To understand the impact of adjusting national drug reimbursement list(NDRL) have on the benefits of patient covered by Basic Health Insurance ( BHI ) , medical insurance fund expenditure and specific drug marketing . Methods: Based on the survey data of medical service utilization situation of national inpatients participated BHI, to summarize and analyze the change of drug usage from 2009 to 2011. Results: In 2011, the drug expense of the national inpatient covered by BHI is approximately 132.7 billion yuan, increased by 37% compared to that of 2009; among which, the expense of entry drug accounts for about 76% out of the total drug use. In 2011, new increased expense on drug use is 13.5 billion, which increased to 98% compared to that of 2009. Conclusion:Adjustment of NDRL had little effect on total drug expenses increasing, but lead changes of the drug expense structure; and expense on some new entry drugs increased obviously. The focus of future adjustment of NRDL could gradually transfer from guaranteeing on basic medicine use to the promotion on clinical rational drug use.

Objective To distinguish primary CMV infection from reactivation or reinfection. Methods A urea denaturation test was included in the washstep of the standard IgG ELISA in 12 patients of age＜12 whose serum CMV-IgG were positive, avidity indexes of CMV-IgG were measured. Results Among children aged 1～12 years, the varieties of avidity indexes of CMV-IgG in A group(IgM negative and IgG positive) and B group(IgM positive and IgG positive) had the same trend. There was only one case in B group whose avidity index was under 30%, the other were all above 30%, and most were above 50%. But among 40 children aged 1～12 months,the avidity indexes were under 30% in 21 cases,8 cases were 30～50% ,and 11 cases were above 50%. The antibody avidity in 1～6 months children was influenced by their mothers lgG,80% (12/15) of 7 ～12 months children had low-avidity antibodies. Conclusion CMV infection mostly occurred among 1～12 months children. Urea denaturation test was an efficient method to distinguish primary CMV infection from reactivation or reinfection.

Objective To explore the reliability and validity of driver coping questionnaire (DCQ) Chinese version. Methods Three hundred and forty drivers were investigated at random by DCQ and positive affect nagative affect scale (PANAS). Results Four factors were extracted, namely active appraisal and coping, confrontive coping, emotion-focused coping and avoidance coping. The correlation coefficients between the questionnaire and the four factors were 0.317 ～ 0. 813 (P ＜ 0.01 ), and the correlation coefficients among the four factors were 0.057 ～0.294. Positive appraisal and coping were correlated with PA positively( r=0. 171, P＜0. 01 ) ,and with NA negatively( r= -0. 349, P＜0.01 ),and the other three coping styles were positively correlated with NA( r=0. 242 ～0.262, P＜0.01 ). The split-half reliability was 0.734,the Cronbach α coefficients of the total questionnaire and four factors were 0. 807,0. 890,0. 621,0. 571and 0. 687 respectively. Conclusion DCQ Chinese version has good reliability and validity, and is an effective instrument to test drivers' coping behavior.

Objective To introduce the idea and the structure of Intelligent Outpatient Queuing System.Methods The hardware was constructed and the software was developed for the application of Intelligent Outpatient Queuing System.Results Run and debugged for one year,the system achieved anticipated results: the outpatient queuing order was effectively improved.Conclusion With a friendly interface,the system is easy to operate and suitable to the complicated situation of an outpatient department.

Acute Lung Injury ; metabolism ; Animals ; Extremities ; blood supply ; Group II Phospholipases A2 ; metabolism ; Male ; Rats ; Rats, Wistar ; Reperfusion Injury ; metabolism ; Taurine ; pharmacology

Animals ; Biogenic Polyamines ; metabolism ; Biological Transport ; Humans ; Paraquat ; poisoning ; Pulmonary Edema ; metabolism

OBJECTIVETo evaluate the effects of Attractin (Atrn) silence on the anti-oxidative and anti-apoptotic abilities of TM4 Sertoli cells and its influence on the expressions of superoxide dismutase (SOD) and caspase6 in the cells.

METHODSWe observed the apoptotic indexes of TM4 Sertoli cells with normal expression (control), partial deletion, and complete deletion of the Atrn gene (psiRNA-TM4, psiAtrn-TM4, and mu-SC). We determined the mRNA and protein expressions of SOD and caspase6 by Q-PCR and Western blot, measured the SOD activity and malondialdehyde (MDA) contentby spectrophotometry, and detected the apoptotic index of the cells by TUNEL.

RESULTSCompared with psiRNA-TM4, after inhibition of the Atrn expression, the Sertoli cells in the psiAtrn-TM4 and mu-SCgroups showed significantly decreased expressions ofSOD mRNA (70.76% and 92.58%) and protein (65.11% and 71.0%) (both P < 0.05). The levels of caspase 6 mRNA and protein were increased 5.28 and 3.40 times in the psiAtrn-TM4 and 2.97 and 2.50 times in the mu-SCgroup as compared with the normal control (both P < 0.05). Atrn deletion markedly increased the apoptotic indexes of the cells in the psiAtrn-TM4 and mu-SC groups by 16.22% and 22.03% (P < 0.05) and reduced the activity of SOD by 23.00% and 39.37% (P < 0.05); it also elevated the level of MDA by 155.22% (P < 0.05).

CONCLUSIONThe Atrn gene exerts influence on the function of Sertoli cells in multiple ways, in which antioxidative stress and apoptosis regulation may play an important role.

Animals ; Apoptosis ; Caspase 6 ; metabolism ; Cells, Cultured ; Gene Deletion ; Male ; Membrane Proteins ; genetics ; metabolism ; Mice ; Oxidative Stress ; Sertoli Cells ; metabolism ; pathology ; Superoxide Dismutase ; metabolism

Child ; Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Infant ; Infectious Mononucleosis ; diagnosis ; Male ; Suppuration ; diagnosis ; Tonsillitis ; diagnosis

Objective To explore the possible pathway and regulatory mechanism of dermal fibroblasts' transdifferentiation into myofibroblasts induced by estrogen. Methods Human dermal fibroblasts were divided into six groups (A: control; B: estrogen; C: estrogen + ICI-182780; D: estrogen + SB203580; E: estrogen + PD98059; F: estrogen + SP600125). The cells were collected for RNA extraction and the expression of α-SMA was detected by real time quantitative RT-PCR. Some cells were analyzed by single cell RT-PCR to detect positive expression percentage of α-SMA.Results The expression and positive rate of α-SMA in estrogen group were significantly increased (Group B vs. Group A, 7. 385±0. 246 vs 1. 367±0. 034, P＜0.01) and those in ICI-182780 group and SP600125 group were significantly inhibited (Groups C and F vs. Group B, 4. 619 ±0. 164,2. 409±0. 091 vs 7. 385±0. 246, P＜0. 05). Conclusions In the process of fibroblast transdifferentiation into myofibroblasts induced by estrogen, estrogen β receptor and JNK-MAPK signal transduction pathway may play an important role.

Objective To observe the effect of intra-articular injection of dehydroepiandrosterone (DHEA)on the experimental osteoarthritis in rabbits and study the mechanism.Methods Forty rabbits un derwent unilateral anterior cruciate ligament transection(ACLT)and then divided into two groups randomly. 100?mol/L DHEA resolved in the dimethylsulphoxide were injected into the knees of experimental rabbits 4 weeks after transection,once a week for five weeks.Rabbits in the control group were treated under the same schedule using dimethylsulphoxide.All rabbits were killed 9 weeks after ACLT and the knee joints were evalu- ated by gross morphology and histology.The mRNA expression of metalloproteinases-3(MMP-3),tissue in- hibitor of metalloproteinases-1(TIMP-1)and interleukin-lbeta(IL-1?)in the cartilage and synovium was analyzed using reverse transcription polymerase chain reaction(RT-PCR).Results Gross morphologic in- spection and histological evaluation showed that the extent and grade of cartilage and synovium damage in the experimental group were less severe than the control group.The mRNA expression of MMP-3 in cartilage and synovium decreased significantly in the experimental group(both P＜0.05).The mRNA expression of TIMP-1 in cartilage and synovium increased significantly in the experimental group compared with that in the control group(both P＜0.05).No significant difference of IL-1?mRNA expression in cartilage was found between the experimental and the control groups(P＞0.05).The mRNA expression of IL-1?in the synovium was signifi- cantly suppressed in the experimental group compared with that in the control group(P＜0.01).Conclusion DHEA protects against cartilage degradation,alleviates synovium inflammation and inhibits the progression of osteoarthritis in the experimental model.Down-regulation of MMP-3 and up-regulation of TIMP-1 in cartilage and synovium and IL-1?in the synovium may be the mechanism of the protective effect of DHEA on os- teoarthritis.