Objective: To evaluate the compensation level of the Urban Employee Basic Medical Insurance ( UEBMI ) and Urban Resident Basic Medical Insurance ( URBMI ) in Jiangsu province . Methods: Take catastrophic health expense as the bottom line of compensation ratio for the basic medical insurance, the benefit of hospitalization expenses of those joining the insurance as the actual line of compensation ratio, and quartile division was used to comparatively analyze the differences between the bottom line of compensation ratio and the actual line of compensation ratio. Results: Take 10%as the critical value of catastrophic health expense, the actual line of compensation level is higher than the bottom line of compensation level in UEBMI, and there is reverse in URBMI. Conclusion: In some extent, the compensation level of UEBMI has relieved the economic burden of the poor jointed group because of sickness, while limited compensation level of UEBMI is in need of further improvement.

To discover factors affecting the inpatient’ actual reimbursement rate of urban resident basic medical insurance ( URBMI ) . Methods: Using the method of correlation analysis and multiple stepwise regression modeling to identify the influencing factors. Results: The per capita funding criteria, rate of inpatient out of pocket payment over resident annual per capita disposable income and per capita hospitalization rate have significant effect on the actual reimbursement rate of URBMI. Conclusion: It is needed to establish a sustainable steady financing mechanisms for URBMI, improve the evaluation system of reimbursement policy and gradually raise the level of actual reimbursement.

As a heparin-binding growth factor, midkine plays an important role in the nervous system, cancer, and inflammatory response.Midkine is involved in the occurrence and development of many autoimmune diseases.This article reviews the role of midkine in renal ischemia reperfusion injury, crescentic glomerulonephritis, lupus nephritis, diabetic nephropathy, and Henoch-Schonlein Purpura nephritis.

Objective To study the optimized process for effective components in Danggui-Buxue pill by orthogona design,and provide the basis for the establishment of quality standard.Methods Ferulie acid and ligustilide were used as examining index,the extraction time,solvent volume and extraction times were used as factors.L9(34) orthogonal test table was used to determine the optimum extraction process.HPLC method was used to establish methodology for ferulie acid and ligustilide.Results According to the result of orthogonal design,comprehensive consider determining the extraction efficiency of ferulic acid and ligustilide the optimal extraction technology as follows:1.0 g Danggui-Buxue pill was extracted by 30 ml of methanol for 60 min,extraction times for 2 times.Conclusions This method is simple with high efficiency.Its HPLC method has high precision and good reproducibility,which can be used for analysis Danggui-Buxue pill.

ObjectiveTo investigate the effect and gender differences of experimental moderate pain on attentional bias towards pain-related words.MethodsWith the tourniquet around the left upper limb,32 healthy college students were asked to perform two dot-probe tasks including five kinds of pain-related words,one task with the tourniquet deflating and the other task with the tourniquet inflating to 200 mm Hg pressure.The reaction time (RT) and the error rate of recognition task were recorded.The pain intensity and distress were recorded too.Results ( 1 ) Compared with no pain condition ( RT of affective and social-threat words were (507 ± 78 ) ms,(504 ±89 )ms respectively),the react time was shorter in female in the condition of tourniquet pain,particularly for affective and social-threat words (the RT were (464 ± 79 )ms,(465 ± 72 )ms respectively,F ( 1,4) =19.157,P ＜0.01 ),but not in male.( 2 ) In condition of no pain,the reaction time of male ( (456 ± 59) ms ) was shorter than that of female (504 ± 79ms).However,in the condition of pain,the significant main effect was not found.ConclusionThe reacting time of female was shorter in condition of moderate tourniquet pain,which imply that female showed significant attentional bias towards affective and social-threat words.

Objective:To investigate the incidence, drug sensitivity and drug resistance characteristies, and theraputic effect of staphylococcal peritoneal dialysis-associated peritonitis (PDAP), aim to provide clinical evidences for standardizing treatment therapy of staphylococcal PDAP. Methods:Clinical data of PDAP patients admitted to the Second Hospital of Jilin University, the First Hospital of Jilin University-the Eastern Division, Jilin Central Hospital and Jilin First Automobile Work General Hospital during January 1, 2013 and December 31, 2019 were retrospectively collected. The results of etiology, drug sensitivity and drug resistance of staphylococcal PDAP patients were collected. According to the pathogenic bacteria, patients were divided into staphylococcus aureus group ( n=48) and coagulase-negative staphylococcus group ( n=232). According to the results of methicillin resistance, patients were divided into drug-resistant group ( n=71) and drug-sensitive group ( n=30). The prognosis of antibiotic therapy in each group were compared. Poisson regression was used to test the changing trend of the incidence of staphylococcal PDAP. The changes of drug sensitivity and drug resistance of staphylococcus were compared between 2013 and 2019 by linear trend χ2 test. Results:A total of 1 085 cases of PDAP occurred in 625 patients were screened, and 280 cases of staphylococcal PDAP were finally included. The incidences of staphylococcal PDAP, staphylococcus aureus PDAP and coagulase-negative staphylococcal PDAP were 0.063 times per patient year, 0.010 times per patient year and 0.053 times per patient year respectively. In addition, the incidence of PDAP caused by staphylococcus, staphylococcus aureus and coagulase-negative staphylococcus decreased year by year (all P<0.05). With the change of years, the sensitivity rate of staphylococcus to rifampicin increased, while the sensitivity rate of staphylococcus to moxifloxacin decreased (both P<0.05). The drug resistance rate of staphylococcus to levofloxacin increased ( P<0.05). The staphylococcus aureus group was more prone to refractory PDAP and catheter removal than that in coagulase-negative staphylococcus group, and the recurrence rate was higher than that in coagulase-negative staphylococcus group (all P<0.05). The proportion of vancomycin used during the whole course of antibiotic therapy in drug-resistant group was higher than that in drug-sensitive group ( P<0.05). Conclusions:The incidence of staphylococcal PDAP decreases year by year, and the drug sensitivity characteristics of staphylococcus also change. The therapeutic outcomes of staphylococcus aureus PDAP are worse than that of coagulase-negative staphylococcus.

To explore the relationship between blood level of big endothelin and contrast-induced acute kidney injury (CI-AKI) in patients with emergent percutaneous coronary intervention (PCI). Methods: A total of 1061 consecutive patients received emergent PCI in our hospital from 2013-01 to 2015-06 were enrolled. According to blood levels of big endothelin, the patients were divided into 2 groups: Normal big endothelin group, n=236 and Elevated big endothelin group, n=825. The baseline condition, procedural features, occurrence rate of CI-AKI and composite endpoint events at 6 and 12 months post-operation were studied which including nonfatal myocardial infarction, revascularization, stroke and all-cause death. The risk factors for CI-AKI occurrence were identified by Logistic analysis. Results: The overall occurrence rate of CI-AKI was 22.7% (241/1061). Compared with Normal big endothelin group, Elevated big endothelin group had the higher incidence of CI-AKI, increased composite endpoint events at 6 and 12 months post-operation with P=0.041, P=0.040 and P=0.021, respectively. With adjusted covariates, elevated blood level of big endothelin, no matter as a continuous variable or categorical variable had the enhanced risk of CI-AKI incidence in patients after emergent PCI. Conclusion: Elevated blood level of big endothelin may significantly increase the risk of CI-AKI in patients with emergent PCI.

Objective To explore the establishment of disabled grade assessment scale for long-term care insurance (LTC).Methods Based on the results of literature review and long-term care needs survey,an initial scale of disabled grade assessment was formulated,then the Delphi method was combined to conduct the consultation on 22 specialists.Results After two rounds of expert consultation,the unanimous disabled grade assessment scale included four first-class indexes of sensation perception,daily activity ability,recognition ability and emotion behavior,the importance mean (M) was 4.64-5.00 points,which ≥4.0 points,the variable coefficient (CV) was 0.00 ％-13.86 ％,which ≤25 ％,the full mark rate (Fr) was 72.73 ％-100.00 ％,which ≥50 ％,recognition rate (Ar) was 90.91％-100.00％,which ≥80％,which indicated that the experts reached a consensus opinion.Among the 22 second-class indexes,the M was 4.27-4.95 points,which ≥4.0 points,CV was 4.20％-25.62％,Fr was 63.64％-95.46％,Ar was 77.27 ％-100.00 ％.The two items of touch sense and getting up from sitting position were newly added,the transferring of table and chair,recent memory and procedural memory were modified into sitting down on the bench and chair,immediate memory and short term memory,the experts reached the consistent opinion.Conclusion The replenished and modified disabled grade assessment scale for LTC has higher authority and expert consistency,which can provide a theoretical reference for the disabled grade assessment work of LTC.

OBJECTIVE:To put forward suggestions for improving the supervision of phase Ⅳ clinical trials in China. METH-ODS:According to summarizing the post-marketing research in America,FDA's supervision(including key elements,supervision flow,auxiliary supervision system and enforcement measures)for drug post-marketing research in America was analyzed,and sug-gestions for the supervision of phaseⅣclinical trials in China was put forward. RESULTS&CONCLUSIONS:The drug post-mar-keting research in America included post-marketing commitment research(PMR)and post-marketing requirement research(PMC). The key elements included supervision subjects(dealt by Office of New Drugs affiliated to Drug Evaluation and Research Center), key document (including the documents helping FDA and applicants reached a research agreement,and documents for process tracking and supervision in identified studies)and important time node. The supervision flow included developing drafts and review-ing reports. FDA had established PMC/PMR database,which was used as auxiliary supervision system,and relevant enforcement measures were respectively developed for PMC and PMR. Relevant supervision departments in China should converse the supervi-sion ideas,give full play to the government's guidance and supervision,enhance the connection of supervision between pre- and post-marketing,specially develop phase Ⅳ clinical program,establish system for phase Ⅳ clinical trial data,enhance whole pro-cess supervision,draw lessons from"pre-process plan,dynamic tracking in the process,and post-process decision according to law"of FDA to improve the supervision of phaseⅣclinical trials in China.

Objective:To analyze the reform of improving the teaching effects of nursing college students' practical training.Methods:Cluster sampling method was used to select 396 nursing college students in a higher nursing school as the research objects, with 197 in experimental group and 199 in control group. Self-directed learning was adopted in practical teaching of surgical nursing in the students in experimental group, and traditional surgery teaching was adopted in control group. Self-rating scale of self-directed learning (SRSSDL) was used every 3 months during the period. The students' self-directed learning ability was measured dynamically, and the scores of practical examination and course satisfaction were compared between the two groups. The data were statistically analyzed by repeated measures analysis of variance and independent sample t-test using SPSS 17.0.Results:The scores of repeated measurement of SRSSDL in the experimental group were higher than those in the control group ( F=16.237, P=0.016). Except for the common surgical instruments module ( P=0.056), the scores of practical training examination in the experimental group were higher than those in the control group, and the differences were statistically significant ( P<0.01 for the operating room nursing module, P=0.005 for the wound nursing module, P<0.01 for the enterostomy nursing module). The students' satisfaction with the overall curriculum in the experimental group was higher than that in the control group. Conclusion:Self-directed learning in the teaching of nursing practice can effectively enhance comprehensive ability and quality of students based on self-directed learning ability, and improve the teaching effect of practical training courses.