Objective To explore the dose-effect relationship and optimal concentration of sodium taurocholate (NaTc) to establish acute necrosis pancreatitis (ANP) complicating MODS in a rat. Methods 280 SD rats were randomly divided into control group (n =40) and 3.5%, 4%, 4.5%, 5% ANP group (n = 60, respectively). ANP groups were induced by retrograde injection of NaTc solution into the pancreatic duct of rats. Rats in each model group were sacrificed at 1, 3, 6, 12 and 24 h after the model induction. Serum amylase, serum total bilirubin, creatinine, blood gas analysis, and pathological changes of pancreas were determined. Survival rate at 24 h after the model induction was observed in other 20 ANP rats in each group. Results In each groups, the serum amylase level, creatinine, blood gas analysis and pathological changes all increased corresponding to the increase of NaTc, and there was significant dose-effect relationship and time-effect. In 4.5% group, the dysfunction of liver and kidney reached the peak at 6 h,while the respiratory dysfunction reached its peak at 12 h. Its incidence of MODS was 52.5%, which was significantly higher than those in 3.5%, 4.0% group (15.0% and 37.5%) ;and 24 h survival rate of 4.5% group was 65%, which was significantly higher than that in 5% group (30%). Conclusions 4.5% NaTc solution may be the optimal concentration to establish the ANP model, which had higher incidence of MODS and 24 h survival rate.

Objective To investigate the time-course change of intra-abdominal pressure (IAP), TNF-α in rat with acute necrotizing pancreatitis (ANP) and its mechanism. Methods 80 SD rats were randomly divided into ANP group and control group. ANP group was induced by retrograde injection of 4.5% sodium taurocholate into the pancreatic duct in SD rats, while control group was induced by injection of saline at the same dosage. Eight rats in each group were killed at 1 h, 3 h, 6 h, 12 h and 24 h, respectively. The serum levels of amylase, TNF-α were determined;IAP, amount of abdominal ascites, pancreatic pathologic changes were evaluated. Results The levels of amylase in ANP group increased progressively with time, which were 32-folds higher than those in control group at 24 h. The serum levels of TNF-α in ANP group reached the peak at 6 h, and were significantly higher than those in the control group. The amount of abdominal ascites increased post-ANP induction and reached the peak at 24 h, which was 4.7-folds higher than that in the control group. The IAP significantly increased 1 h after induction, which was 3 times as high as the control group in 3 h group and 9 times in 12 h group. Pathologic injuries deteriorated progressively and reached the peak at 24 h. Conclusions Significant IAP occurred in ANP rats and reached the peak at 12 h, TNF-α reached the peak at 6 h, therefore IAP may be the secondary response to inflammatory reaction.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.

Taking the scope of outpatient special disease,the level of protection and the fixed-point management as the entry point.Under the"N+X"policy background,it reviewed the policies related to outpatient special diseases in 13 co-ordinated districts of Jiangsu Province to explore the similarities and differences and the existing problems,and provide relevant suggestions.Jiangsu Province has issued a guiding document to establish a unified outpatient special disease system,the differences in the scope of outpatient special disease and the medical insurance benefit level in the 13 cities should not be ignored.These differences may affect the fairness of patients and hinder the establishment of a unified outpatient special disease system in the province.In addition,there are still some problems in the selection of diseases,hierarchical medical,and disease identification.It is recommended to establish a dynamic selection mechanism for outpatient special diseases,to fully utilize the role of primary healthcare institutions in providing outpatient services for special diseases,and to develop objective and unified criteria for identifying outpatient special diseases.