This paper reviews outpatient security policy of typical developed countries .It provides reference for outpatient security system in China .Analysts believe that the experience for Chinese reference should be acquired in the following ways:The pooling of outpatient service is an inevitable trend in the development of health insurance , which is in principle an integral part of payment and financing system; the implementation of outpatient community first diagnosis system should be adapted to the local conditions; the community first diagnosis system is a necessary condition for capitation , so it is closely related to compensation methods and the elaborate degree of outpatient treat -ment catalog;Outpatient services should be supervised and payment policies should be developed respectively .There are two supervision models about outpatient service:external supervision and self supervision , but the key is to focus on the management of outpatient doctors .External regulation should be consistent with the current regulatory approach of the situation and patients have to bear some responsibilities for outpatient treatment expenses in some proportions , but the payment cap line should not to be low .The implementation of certain preferential policies for vulnerable groups can be considered under the harmonized system to partially reduce their medical expenses .

Objective:To observe the expression of P70 S6 kinase(P70 S6K) in parotid acinic cell carcinoma. Methods:P70 S6K expression was examined by means of SP immunohistochemical technique and Western blot test in 30 cases of parotid acinic cell carcinoma. Results:Western blot revealed that P70 S6K expression in parotid acinic cell carcinoma was 58% higher than that in normal parotid tissue. Immunohistochemical assay showed that positive expression ratio of P70 S6K in parotid acinic cell carcinoma and in normal parotid tissue was 100.0% and 33.3%(P

Objective To determine the minimum alveolar concentration(MAC) of sevoflurane without body movement during laryngeal mask airway(LMA)intubation in premature infants less than 37 weeks of corrected gestational age undergoing total inhalation general anesthesia induction.Methods Twenty-one ASA Ⅰ or Ⅱ premature infants less than 37 weeks of corrected gestational age undergoing elective inhalation general anesthesia were enrolled in this study.At first,the general anesthesia induction was started by inhaling 6 ％ sevoflurane.After the premature infant lost consciousness,the end tidal sevoflurane concentration(ET-sev)was adjusted to the predetermined concentration and maintained stable for 15 min.After that,LMA was inserted.The up-anddown sequential allocation was used to determine MAC.The initial ETsev was 2 ％,which was increased or decreased by 1 gradient concentration in the next case according to the LMA insertion body movement response.The adjacent concentration gradient was 0.2％.The midpoint from th body movement response to non-body movement response was set as the balance point and the mean value of the concentrations of sevoflurane at all the balance points were calculated as MAC.Results The end tidal sevoflurane con centration without the body movement responses to LMA insertion was 1.71％.Conclusion The MAC of sevoflurane without the body movement responses to LMA insertion in premature infants less than 37 weeks of corrected gestational age is 1.71％,which is lower than that in the normal children and probably because imperfect central nervous system development in premature infants.

Objective To evaluate the influence of different surface roughness on final surface texture of glazed ceramic. Methods Sixty porcelain discs were fabricated and randomly divided into five groups (n=12), which were sequentially grounded with water-cooled sandpapers of decreasing abrasiveness (220# , 400# , 600# , 800# and 1200# grit), and then all the specimens were glazed. Before and after glazing, the surface roughness (Ra) μm of the same specimens were evaluated quantitatively with profilometer and qualitatively using scanning electron microscopy (SEM). Results The smoothest surfaces were obtained with 1 200# sandpapers griting prior to overglazing (Ra =0. 19 μm),and 220# sandpapers griting prior to overglazing displayed the roughest surfaces (Ra =0. 55 μm) ; each group displayed significant difference before and after glazing (P < 0. 05). The images obtained through SEM were consistent with the profilometer readings. Conclusions The results suggest that decreasing the surface roughness of dental ceramic prior to glazing is of great importance in order to obtain the smoothest surface after glazing.

Objective To investigate the efficacy of centrally fixed eyeball for assessment of the depth of anesthesia in premature infants undergoing outpatient fundus examination. Methods Fifty eight premature infants undergoing examination of fundus of eyes were enrolled in this study. Their gestational age (from the first day of last menstruation period to birth) + after birth age (from birth to the day when examination of fundus of eyes was performed) = 44-64 weeks. The patients were randomly divided into 2 groups: Ⅰ group body movement (group M, n = 27) and Ⅱ group centrally fixed eyeball (group E, n = 31). Anesthesia was induced and maintained with isoflurane inhalation. The patients were breathing spontaneously. The eyelids were kept open with speculum after induction of anesthesia. The EC50 of sevoflurane concentration which could inhibit body movement or make eyeballs centrally fixed was determined by up-and-down sequential experiment. The initial isoflurane concentration was 3% in both groups. Each time the isoflurane concentration was increased/decreased by 0.5 %. 95 % confidence interval (CI) was calculated. The lowest SpO2, respiratory rate and coughing during maintenance of anesthesia were recorded. Results The EC50 of sevoflurane (95% CI) was 2.9% (2.2%-3.6%) in group M and 3.4%(2.6%-4.6%) in group E. Examination was successfully completed in all patients. No respiratory depression and coughing occurred during examination and no vomiting and coughing were observed during feeding at 1 h after recovery from anesthesia. No body movement occurred in 15 patients whose eyeballs were centrally fixed in group E. Conclusion Centrally fixed eyeball can be used as sign of appropriate depth of anesthesia for fundus examination in premature infants.

With the deepening of modernization of traditional Chinese medicine (TCM), the method of quantification and standardization of TCM (i.e., quantitative characterization of TCM) has been more and more widely accepted by researchers. Chemometrics processes complicated data of TCM through applied mathematics, statistics and com-puter technology. And multivariable study was introduced into the quantitative characterization of TCM with great achievements. This article reviewed existed problems of quantitative characterization in TCM, the principles, char-acteristics, limitations, commonly used statistical methods and application conditions on quantitative characteriza-tion of TCM. With this review, a reference for further study of quantitative characterization of TCM was provided and a further research idea of combination with main methods of chemometrics was given.

Objective To determine the minimum alveolar concentration for endotracheal intu-bation (MACEI )of sevoflurane for curbing the responses to endotracheal intubation in 50% premature infants less than 37 weeks of corrected age.Methods Twenty-seven ASA Ⅰ or Ⅱ premature infants less than 37 weeks of corrected age were enrolled in this study.At first,the anesthesia induction was started by inhaling 6% sevoflurane.After the patient lost consciousness,the end tidal sevoflurane concentration (CET Sev)was adjusted to the target concentration and maintained stable for 1 5 min.En-dotracheal tube was then intubated.The up-and-down sequential method was used to calculate the MAC.The initial CET Sev was 3.0% and it was increased or decreased by 0.2% in the next patient ac-cording to the endotracheal intubation response.If the intubation response was positive,the CET Sev was increased;if the intubation response was negative,the CET Sev was decreased.The midpoint from negative response to positive response was set as a balance point and the mean value of the concentra-tions of sevoflurane at all the balance points were calculated as MACEI .Results The end tidal sevoflurane concentration for blunting the responses to endotracheal intubation in 50% premature in-fants was 2.55%±0.20%,and the MAC9 5 was 2.81% (95% confidence interval 2.67%-3.58%). Conclusion The MACEI of sevoflurane for curbing the responses to endotracheal intubation in 50%premature infants less than 37 weeks of corrected age is 2.55%,which is lower than that in the full-term children.

AIM: To explore the effect of drug content and encapsulated efficency of microsphere ophiopogon saponin preparation, providing more precise computational method. METHODS: Ophiopogon saponin enteric microsphere was prepared by spray drying technique, and the sum of saponin was determined by colorimetric analysis to evaluate the drug content and encapsulated efficency. RESULTS: The encapsulated efficency (%) was 94.75? 2.68. The drug content (mg/g) was 54.81? 2.12. CONCLUSION: The drug content the encapsulated efficency can affect the clinical dosage and the encapsulated efficency stands for the preparation process and the quality. So we should detect both drug content and the encapsulated efficency to evaluate preparation quality evaluation.

AIM: To explore the influencing factors in the release rate and give the application to the preparation. METHODS: Preparing ophiopogon saponin enteric microsphere by spray drying process,the accumulative release rate of acid and buffer solution were detected by colorimetric analysis. RESULTS: With the increase of Eudragit Ⅱ concentraction,the accumulative release rate tended to decrease.But ratio of drug and Eudragit Ⅱ,increased with the decrease in delay time on the break point. CONCLUSION: The concentration of Eudragit and the ratio of drug and material are the rey factors in the accumulative release rate in acid and buffer solution.

Objective To explore the prescription factor on Ophiopogon japonicus saponin enteric microsphere by spray drying technique. Methods Observing the type and content of enteric coating material, the type of plasticizer, the type and dosage of antistickiness material by single factor. Optimizing the prescription by orthogonal test design. Results Both Eudragit Ⅱ and micronization silica gel made in China could meet the need of the preparation. The best prescription included the proportion between drug and enteric coating material (1∶4), the dosage of castor oil (1%), and the dosage of micronization silica gel (1.5%). Conclusion O. japonicus saponin enteric microsphere accorded with the expecting demand. The kind of medical subsidiary material made in China will be the main raw material in producing the enteric microsphere. The study of prescription design will provide the basis for realizing microencap-sulation in Chinese materia medica.