1.Overview and enlightenment on the government compensation mechanism at some public hosital
Li XIANG ; Wu ZHOU ; Bo FENG ; Lan YAO
Chinese Journal of Hospital Administration 2012;28(7):553-556
This paper overviewed typical government compensation sources and practices for public hospitals in the world.Government compensation should be made based on regional health planning,while the central government shoulders greater compensation responsibility.The fee-for-case mix is found to be the best incentive The government adjusts its funding baselines for different hospitals to adjust the compensation.In view of the compensation for public hospitals in China,the paper analyzed the enlightenments and lessons from international experiences The authors recommend an evolution from the pattern of compensation per person/per bed,to payment by service unit or volume(for example,per outpatient or emergency visit and days of stay),and in the end to that of payment per disease.
2.Molecular identification of aucklandiae radix, vladimiriae radix, inulae radix, aristolochiae radix and kadsurae radix using ITS2 barcode.
Xiao-Chong MA ; Hui YAO ; Lan WU ; Li XIANG ; Xiao-Chen CHEN ; Jing-Yuan SONG
China Journal of Chinese Materia Medica 2014;39(12):2169-2175
In order to identify Aucklandiae Radix, Vladimiriae Radix, Inulae Radix, Aristolochiae Radix and Kadsurae Radix using ITS2 barcodes, genomic DNA from sixty samples was extracted and the ITS2 (internal transcribed spacer) regions were amplified and sequenced. The genetic distances were computed using MEGA 5.0 in accordance with the kimura 2-parameter (K2P) model and the neighbor-joining (NJ) phylogenetic tree was constructed. The results indicated that for Aucklandiae Radix (Aucklandia lappa), Vladimiriae Radix (Vladimiria souliei and V. souliei var. cinerea), Inulae Radix (Inula helenium), Aristolochiae Radix (Aristolochia debilis) and Kadsurae Radix (Kadsura longipedunculata), the intra-specific variation was smaller than inter-specific one. There are 162 variable sites among 272 bp after alignment of all ITS2 sequence haplotypes. For each species, the intra-specific genetic distances were also smaller than inter-specific one. Furthermore, the NJ tree strongly supported that Aucklandiae Radix, Vladimiriae Radix, Inulae Radix, Aristolochiae Radix and Kadsurae Radix can be differentiated. At the same time, V. souliei (Dolomiaea souliei) and V. souliei var. cinerea( D. souliei var. cinerea) belonging to Vladimiriae Radix were clearly identified. In conclusion, ITS2 barcode could be used to identify Aucklandiae Radix, Vladimiriae Radix, Inulae Radix, Aristolochiae Radix and Kadsurae Radix. Our study may provide a scientific foundation for clinical safe use of the traditional Chinese medicines.
Aristolochia
;
classification
;
genetics
;
Base Sequence
;
DNA Barcoding, Taxonomic
;
methods
;
DNA, Plant
;
genetics
;
DNA, Ribosomal Spacer
;
genetics
;
Drugs, Chinese Herbal
;
chemistry
;
classification
;
Molecular Sequence Data
;
Phylogeny
;
Plants, Medicinal
;
classification
;
genetics
;
Quality Control
3.Clinical observation on treatment of albuminuria in patients with pregnancy-induced hypertension syndrome in puerperium by Xiaobai Decoction.
Jin-ping JIA ; Yao-xiang WU ; Guo-hong XIE
Chinese Journal of Integrated Traditional and Western Medicine 2007;27(7):644-646
OBJECTIVETo observe the effects of Xiaobai Decoction (XBD) in reducing albuminuria and shortening the duration of albuminuria in patients with pregnancy-induced hypertension syndrome (PIH) in puerperium.
METHODSEighty-five patients were given the conventional treatment with magnesium sulfate for relieving convulsion and lowering hypertension, at the same time, the treated group was given XBD additionally with the modification according to the symptoms. The treatment course for both groups was 14 days. Routine test of midstream urine was performed every three days, and 24 h-urinary protein was measured every week.
RESULTSThe therapeutic effect on the 43 patients of the treated group was markedly effective in 11 (25.6 % ), effective in 26 (60.4%) and ineffective in 6 cases (14.0%), the total effective rate being 86.0%; while in the 42 patients of the control group, the corresponding numbers were 5 (11.9%), 21 (50.0%), 16 (38.1%) and 61.9%, respectively, the efficacy of the former was significantly better (P < 0.05).
CONCLUSIONXBD is a simple, safe and effective drug for reducing albuminuria and shortening the duration of albuminuria in puerperium of PIH patients.
Adult ; Albuminuria ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension, Pregnancy-Induced ; drug therapy ; Phytotherapy ; Postpartum Period ; Pregnancy ; Treatment Outcome ; Young Adult
4.Study of negotiation mechanism at designated hospitals at provincial level for catastrophic diseases
Huiqiu LUO ; Yao PAN ; Cong LI ; Shude WU ; Shanquan CHEN ; Yunfei LI ; Li XIANG
Chinese Journal of Hospital Administration 2015;31(1):65-69
Stakeholder theory and game theory were applied to analyze the stakeholders,role definition,participation,interest,power,position and the shift of positions under different conditions in the negotiation.Use SPSS 17.0 to analyze the database of NCMS in 2009~2010 in three counties of Hubei province,and then employ Linear programming method to do a case study of price negotiation.It is difficult to meet all stakeholders' expectations under the current condition of catastrophic disease insurance pooled at municipal-level.Medical cost differences in tertiary hospitals at provincial level are small for different regions,which constitute a basis for price negotiation at provincial level.Besides,the negotiation at province level can effectively address the conflicts of interest,and promote the negotiations.Negotiation at provincial level for such diseases,and formulating unified pricing standards for multi-wins.
5.Study on the status of catastrophic disease medical assistance under NRCMS in A City at Hubei Province and B County at Guizhou Province
Huiqiu LUO ; Shude WU ; Cong LI ; Yunfei LI ; Yao PAN ; Li XIANG
Chinese Journal of Health Policy 2015;8(3):24-28
Objective:This paper designs to analyze the status of catastrophic disease medical assistance in A and B regions, and put forward feasible suggestions to improve the medical assistance level and financial effects. Methods:We selected A city at Hubei province and B county at Guizhou province as sample areas, and obtained 872 copies of questionnaires in the field survey. Then, out-of-pocket health expenditure per year, the incidence, and rel-ative gap of catastrophic health expenditure before and after the financial aid were calculated. Results: Catastrophic disease medical assistance plays a limited role in relieving patients' economic burden. Low financial aid rate, narrow range, high deductibles and low ceiling level are responsible for much lower effective financial aid rate. Conclusion:Raise financial aid rate and widen the scope of medical assistance gradually;Establish effective link-up between cata-strophic disease medical assistance and catastrophic disease insurance / basic medical insurance;Put outpatient OOP into the scope of catastrophic disease medical assistance.
6.Application of dextran sulfate pretreatment in animal model of umbilical cord blood transplantation
Jianqiu WU ; Zhijun JIN ; Yingsong XIANG ; Yunfang YANG ; Rujun YANG ; Ming YAO ;
Academic Journal of Second Military Medical University 2000;0(08):-
Objective: To better understand homing potentiality of hematopoietic stem cells (HSC) in human umbilial cord blood (UCB) and the mechanism of dextran sulfate (DS) mobilization. Methods: Sub lethally irradiated or DS pretreated severe combined immunodeficient (SCID) mice were transplanted with UCB, which was cryopreserved at -80℃.Human cells in recipient mice were detected by flow cytometry and CFU GM assay from each host organ. Results: In contrast with the controls, engraftment after irradiation or administration of DS resulted in a higher percentage of CD45 +,CD34 +,CD19 + cells produced in SCID mice. While comparison between the experimental groups, higher implantation level was obtained in the former if equivalent donor cells were used in both groups. Conclusion:DS is a safe and effective pretreatment, which can mobilize HSC, but also vocate niches for transplanted HSC homing. [
7.Rapid analysis of astragalus and its extracts by infraredspectroscopy
Yizhen GUO ; Wenjing PANG ; Suqin SUN ; Jingjuan WANG ; Haozhong WU ; Yao XIAO ; Lina LU ; Li XIANG ; Yanfang YANG
International Journal of Traditional Chinese Medicine 2015;(5):431-434
Objective To provide effective reference for quality analysis of the chemical composition and extraction of astragalus separation process by comparing the extract of astragalus and it’s IR spectra. Methods The saponins and flavonoids in astragalus were firstly extracted by the method of circumfluence with ethanol as solvent and the residue of ethanol-extraction was then used to extract polysaccharides by distilled water. Fourier transform infrared spectroscopy (IR) combined with second derivative infrared spectroscopy was applied to quickly identify astragalus herbs powder, water extraction of astragalus, astragalus alcohol extraction and water extraction of the residue of ethanol-extraction. Results The powder and 70% ethanol extract, 80% ethanol extract were around at 1 735 cm-1 (carbonyl stretching vibration absorption peak) has a weak, broad absorption, while the absorption peak was less obvious in boiling water extraction. So the maln components of astragalus water extraction are polysaccharides and also contaln a small amount of water-insoluble flavonoids. Alcohol extraction malnly contalns saponins and flavonoids, and flavonoid extract volume increases with increasing alcohol concentration in a certaln range.Conclusion This method can be a quick and easy identification for astragalus and it’s extraction for its chemical composition class, and provide the basis for further research quality.
8.A clinical and pathologic study of meibomian gland carcinoma with reduplicative operations
Xiang-hua, WU ; Yong-ping, LI ; Ping, ZHANG ; Wen-xin, ZHANG ; Jian-xian, LIN ; Jian-liang, ZHENG ; Juan, YAO
Chinese Journal of Experimental Ophthalmology 2012;30(5):437-440
BackgroundThe meibomian gland carcinoma is an eyelid malignant tumor with a domestic incidence after basal cell carcinoma.Meibomian gland carcinoma is not sensitive to radiation therapy and chemotherapy,and the related factors with its recurrence and metastasis are rarely reported.ObjectiveThis study was to investigate the clinical and pathologic features of meibomian gland carcinoma with multiple operations and the effectiveness of histologically controlled excision.MethodsThe clinical data and the histopathologic sections of 34 cases of the meibomian gland carcinoma diagnosed by pathology were retrospectively analyzed at Zhongshan Ophthalmic Center in September 2003 to April 2011,and the treating effectiveness of histologically controlled excision was evaluated. ResultsIn this group of cases,the appearing rate of the meibomian gland carcinoma was resemble in both lateral eyes.A higher morbidity was on the upper eyelid (26/34,76.5%) and then the lower eyelids (5/34,14.7% ) and both (3/34,8.8%).The average ages of these cases were 57.5 years old.Sixteen of 21 misdiagnosed cases were identified as chalazion at the first visit,and no histopathological examination was performed in 11 cases after initial operation.Twenty-six cases(76.5% )were identified as meibomian gland carcinoma in initial histopathologic diagnosis.Two cases had histologically controlled excision and 16 cases had simple excision while 16 cases had chalazion enucleation in the first operation.All the patients had histologically controlled excision in Zhongshan Ophthalmic Center with 58.8% of the patients having pagetoid invasion.Sixteen cases were followed up for 5 months to 8 years after histologically controlled excision,in which none died of recurrence and metastasis of meibomian gland carcinoma.No significant differences were found in the pathological feature between 16 lost patients and 18 followed-up patients(P > 0.05 ).Conclusions Misdiagnosis of meibomian gland as chalazion is a main cause of repeat operations of meibomian gland carcinoma.Histologically controlled excision is a feasible therapy for the recurrence and metastasis of meibomian gland carcinoma.
9.Study on variations of mtDNA from high and low metastatic mouse hepatocarcinoma cell sublines
Jigang DAI ; Yingbin XIAO ; Jiaxin MIN ; Guoqiang ZHANG ; Mingzhang XIANG ; Qiuping WU ; Ke YAO ; Renjie ZHOU ; Zubin YU
Journal of Third Military Medical University 2003;0(20):-
Objective To investigate the variations of mtDNA from high and low metastatic mouse hepatocarcinoma cell sublines Hca-F and Hca-P, and the relationship between mutations of mtDNA and carcinogenesis. Methods The variations of D-loop, ND3 and tRNA Met+Glu+Ile gene fragments of mtDNA from Hca-F and Hca-P cells were analyzed by PCR-RFLP and sequencing techniques. Results No amplification fragment length polymorphism and restriction fragment length polymorphism were observed in tRNA Met+Glu+Ile , ND3 and D-loop of mtDNA from the 2 cell sublines. Sequence difference between these 2 cell sublines were found in mtDNA D-loop region by sequencing. Conclusions Genetic alteration of mtDNA non-coding region in tumors, which may reflect the environmental and genetic influences operative during tumor progression, can be linked to their tumorigenic phenotype.
10.Study on 4977 bp deletion mutation of mitochondrial DNA in non-small lung cancer
Jigang DAI ; Yingbin XIAO ; Jiaxin MIN ; Guoqiang ZHANG ; Mingzhang XIANG ; Qiuping WU ; Ke YAO ; Renjie ZHOU ; Zubin YU
Journal of Third Military Medical University 2003;0(21):-
Objective To study the 4 977 bp deletion of mitochondrial DNA in lung cancer, paraneoplastic tissue and normal lung tissue from non-lung cancer subjects and its significance in the development of cancer. Methods Lung cancer tissues and paraneoplastic tissues from 37 non-small lung cancer patients, and normal lung tissues from 20 patients without lung cancer were analyzed by long PCR technique. Results Mitochondrial DNA 4 977 bp deletion was detected in 54.1%(20/37) of lung cancer tissues, 59.5%(22/37) of paraneoplastic tissues and 30.0%(6/30) of normal lung tissues. The correlation between 4 977 bp deletion and age, smoking was present in our data. Conclusion Mitochondrial DNA 4 977 bp deletion, which may reflect the environmental and genetic influences during tumor progression, is not specific to lung cancer and unlikely to play an important role in carcinogenesis.