Widely accepted in other countries,DRG payment is also referred to in China now and then.The authors reviewed the status quo of medical payment in China,as well as the practices and studies of DRG payment overseas.Based on such studies,the paper probed into the feasibility of DRG application in China,in terms of policy environment,application demand,research basis and technical conditions.Proposed in the paper are ranges of application,possible roadblocks and countermeasures for the application in China,aiming to promote the research,application and use of the method in China.

Objective: To explore the inhibition effects of ectogenic wild type p53 cDNA(Ad wtp53) on colorectal carcinoma cell lines with different p53 gene status and search for the role of wild type p53 tumor suppressor gene in occurrenc and progress of malignant tumor. Methods: MTT process was taken to choose optimal transfection titre. Three kinds of cell lines(p53 gene deletion, mutation and nomal) were transferred by Ad wtp53 in optimal titre. The inhibition effects of these cell lines were observed and compared. Results: The best titre is 1000 MOI and p53 gene deletion cell line (THC 8908) shew the highest sensitivity. G 1 S transition period blocking effects occurred in all cell lines and G 2 M phase regulation effects were not coincidence in three colorectal cell lines. Conclusions: Recombinant adenovirus mediated wild type p53 gene observably inhibited colorectal carcinoma cell lines growth and proliferation, blocked cell cycle in G 0 /G 1 phase and displayed obvious different actions on G 2 M phase among cell lines with different p53 status.

Objective To explore the effect and molecular mechanism of proteasome inhibitor in TNF-related apoptosis-inducing ligand (TRAIL)-induced apoptosis resistance on malignant lymphoma cells.Methods Raji cells were treated with TRAIL and proteasome inhibitor (PS-341) in vitro and the cell growth index was evaluated by MTT assay; cell cycle was analysed by flow cytometry; the protein and mRNA level of Bax were measured by Western blotting and real time RT-PCR. Results TRAIL inhibited proliferation of Raji cells at the concentration of 500 μg/L, but the inhibition rate was lower than that of the control cell:Hmy2.ciR.TRAIL arrested cell in G0/G1 phase. The Bax protein in Raji is degraded, but the Bax mRNA expression level does not change significantly .The effects of TRAIL was enhanced significantly 10 nmol/L PS-341 was added. Conclusion Raji cells are resistant in TRAIL-induced apoptosis. This effect may be related to the decrease of Bax protein. The Ubiquitin-proteasome pathway is involved in the degradation of Bax in TRAIL-treated Raji cells.

Ex-vivo liver resection and liver autotransplantation offers a chance to cure extensive regional liver diseases which are otherwise deemed untreatable in selected cases. A 33-year-old male patient with advanced alveolar echinococcosis (AE) which invaded the right lobes and adjacent retrohepatic inferior vena cava, while the left lobes were free from lesion and had proliferated to over 1200 ml in size except for a 1 cm × 1 cm solid lesion in the segment Ⅳ. No extrahepatic metastases were found in this patient. A lesion with a size of 4300 ml and other small lesions in the right lobes were removed extracorporeally,and the retrohepatic vena cava was repaired, then the remaining AE-free left lobes (more than 700 ml in size) and the retrohepatic inferior vena cava were re-implanted in situ. A temporary end-to-end cavo-caval shunt with interposition of a blood vessel prosthesis and end-to-side portocaval shunt were established to keep the blood flow during the four-hour anhepatic phase. The patient was followed up for six months, and he had no signs of residual liver disease with good hepatic function.

Objective To study the clinical efficacies of different surgical palliative treatments for patients with advanced pancreatic carcinoma.Methods A retrospective analysis was conducted on the clinical data of 119 patients with advanced pancreatic carcinoma who were treated in the department of General Surgery of Linyi's Central Hospital from January 2010 to January 2016.According to the different surgical methods the patients received,they were divided into the seed group (n =38),the radiofrequency ablation (RF) group (n =52) and the control group (n =29).Patients' general data,operation data,postoperative complications and follow-up profiles were analyzed.Results There was no significant difference in the patients'general data among the three groups of patients (P ＞ 0.05).The incidences of postoperative complication in the seed group,the RF group and the control group were 55.3％,38.5％ and 20.7％,respectively.There was significant differences between the incidences of postoperative complications between the seed group and the control group (P ＜ 0.05).There was no perioperative death.The postoperative follow-up rate was 91.6％.Pain in the seed group and the RF group significantly improved,while it was not significantly improved in the control group.There were significant differences in the postoperative pain scores (P ＜0.05).The 6 months,1-year and 2-year overall survival rates were 61.3％,25.9％,8.6％ respectively.The median survival was 8 months.In the seed group,the 6 months,1-year and 2-year survival rates were 75.2％,37.8％,18.9％ respectively.The median survival was 9 months.In the RF group,the 6 months,1-year and 2-year survival rates were 60.4％,25％,6.3％ respectively.The median survival was 8 months.In the control group,the 6 months,1-year and 2-year survival rates were 53.4％,15.3％,3.8％ respectively.The median survival was 6.5 months.On log-rank test,there was no significant difference in survival rates among the three groups (P =0.145).Conclusions Patients with advanced pancreatic carcinoma had poor prognosis.I125 radioactive particles implantation and radiofrequency ablation were useful to improve patients'quality of life and prolonged their survival.

BACKGROUNDTo compare the effect and toxicity between gemcitabine and cisplatin (GP) with vinorelbine, ifosfamide and cisplatin (NIP) combined chemotherapy in the treatment of patients with advanced non-small cell lung cancer (NSCLC).

METHODSEighty patients received either gemcitabine 1 000 mg/m² on days 1, 8, or 15 plus cisplatin 70-80 mg/m² on day 1, or vinorelbine 25 mg/m² on days 1, 8, ifosfamide 1.2 g/m² on days 1-4 plus cisplatin 70-80 mg/m² on day 1, every 28 days as a cycle.

RESULTSThe objective response rate was 40.0% in GP goup, compared with 52.5% in NIP group (P > 0.05). Median survival time of GP and NIP groups was 13.68 and 15.34 months respectively, and 1-year survival rates were 54.29% and 59.46% respectively (P > 0.05). Leukopenia at grade III+IV was significantly lower in GP arm (27.5%) than that in NIP arm (55.0%) (P < 0.05). Non-hematological toxicities were less frequent in GP group than those in NIP group (P < 0.05).

CONCLUSIONSAlthough the response rate tends to be higher in three-drug than in two-drug combined chemotherapy, but no significant difference is observed. Three-drug combinations often result in more toxicities. Two-drug combination GP may be the standard protocol for chemotherapy of advanced NSCLC. Three-drug combination NIP should be given to young patients with good performance status.

Objective To explore and analyze the effects of ω-3 polyunsaturated fatty acid(PUFA)on oxidative stress and Toll like receptor-4(TLR4)and tumor necrosis factor alpha(TNF-α)in rats with acute lung injury(ALI)induced by lipopolysaccharide (LPS).Methods 120 healthy adult Wistar rats(clean grade;weight,180-240 g)were randomly divided into control group and ob-servation group,60 rats in each group,rats in the control group were randomly divided into untreated group,6 h group(LPS injec-tion),and 24 h group(LPS injection),20 rats in each group.The rats in the observation group were randomly divided into untreated group,6h group(PUFA+LPS injection),and 24 h group(PUFA+LPS injection),20 rats in each group.The relative expression of Superoxide Dismutase(SOD)before treatment,6 h after treatment and 24 h after treatment,Malondialdehyde(MDA),intercellular cell adhesion molecule-1(ICAM-1),TNF-α,and TLR4 in two groups were observed.Results The difference of SOD levels before and after treatment in the two groups of rats was statistically significant(P<0.05),the difference of SOD levels before treatment in the two groups of rats was not statistically significant(P> 0.05).As the processing time went on,the level of SOD in the two groups of rats decreased,but the decrease of the rats in the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05),the difference of MDA level before and after treatment in two groups of rats was statistically significant(P<0.05).As the processing time went on,The level of MDA in the two groups of rats increased,but the increase of the rats in the observation group was significantly lower than that of the control group,and the difference was statistical-ly significant(P<0.05).The difference of ICAM-1 level before and after treatment in the two groups of rats was statistically signif-icant(P<0.05).As the processing time went on,the levels of ICAM-1 and TNF-alpha in the two groups increased,but the increase of the rats in the observation group was significantly lower than that in the control group,the difference was statistically significant (P<0.05).The relative expression of TLR4 in the lung tissue of the observation group was significantly lower than that of the control group(P<0.05).Conclusion PUFA could effectively reduce the oxidative stress and inflammation in ALI rats induced by LPS,which may contribute to the treatment of ALI.

The SNP loci of ACOX1 gene in 83 China Holstein cows were detected by PCR amplifica-tion and direct sequencing,and the association between the genetic polymorphism loci of ACOX 1 gene and milk quality traits of China Holstein cows was analyzed by SPSS 25.0 software.The re-sults showed that a SNP locus I3-2 267 G→C was found in the third intron of ACOX1 gene,it was moderately polymorphic and in Hardy Weinberg equilibrium in the population.By correlation anal-ysis,it was found that the SNP locus was significantly related to the somatic cell content and cor-rected milk quantity of dairy cows.The I3-2 267 G→C locus of ACOX1 gene can be used as a mo-lecular marker of quality traits of Holstein cows in China,and provide reference for the study of quality traits of Holstein cows in China.

ObjectiveTo clarify the therapeutic effect of Huashi Baidu prescription on pneumonia in mice caused by influenza A （H1N1） virus and explore its mechanism based on the transcriptome. MethodA mouse influenza viral pneumonia model was built by intranasal infection with influenza A virus， and mice were continuously administered the drug for five days， so as to investigate the general condition， lung index， viral load， pathological morphology of lung tissue， survival time， and prolongation rate of survival time of mice and clarify the therapeutic effect of Huashi Baidu prescription on influenza viral pneumonia. Transcriptome technology was used to detect the differentially expressed genes in the lung tissue of mice in the model group and the normal group， as well as the Huashi Baidu prescription group and the model group， and the potential core target of the Huashi Baidu prescription for the treatment of influenza viral pneumonia was screened. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to verify the effect of Huashi Baidu prescription on the mRNA expression level of core target genes. ResultCompared with the normal group， the lung index and viral load in the lung tissue of the model group were significantly increased （P<0.05， P<0.01）. Compared with the model group， the high-dose group of Huashi Baidu prescription significantly prolonged the survival time of mice infected with influenza A virus （P<0.05） and significantly reduced the lung index value of mice （P<0.05） and the viral load of lung tissue. The high-dose， medium-dose， and low-dose groups of Huashi Baidu prescription could significantly reduce lung tissue inflammation， blood stasis， swelling， and other pathological changes in mice （P<0.05， P<0.01）. Transcriptome analysis of lung tissue showed that core genes were mainly enriched in the nuclear transcription factor-κB （NF-κB） signaling pathway， interleukin-17 （IL-17） signaling pathway， cytokine-cytokine receptor interaction， and other pathways after the intervention of Huashi Baidu prescription. TRAF6， NFKBIA， CCL2， CCL7， and CXCL2 were the top five node genes with combined score values. Real-time PCR validation showed that Huashi Baidu prescription significantly downregulated the mRNA expression of key genes TRAF6 and NFKBIA in the NF-κB signaling pathway， as well as chemokines CCL2， CCL7， and CXCL2 （P<0.05， P<0.01）. ConclusionHuashi Baidu prescription has a therapeutic effect on influenza viral pneumonia， possibly by inhibiting the expression of key nodes TRAF6 and NFKBIA in the NF-κB signaling pathway and that of chemokines CCL2， CCL7， and CXCL2， reducing the recruitment of inflammatory cells and viral load， and exerting anti-influenza viral pneumonia effects.