AIM To elucidate whether apoptosis is involved in the development of multidrug resistance in 5-fluorouracil resistant cells Bel7402/5-FU. METHODS Multidrug resistance of Bel7402/5-FU cells was determined by SRB assay, apoptosis was measured by Annexin V-FITC/PI double labeled assay, cell cycle phases were analysed by flow cytometry, and expression of genes related to apoptosis bcl-2, bcl-xl, bcl-xs, bax, fas, p53, and cpp32 was detected by RT-PCR assay. RESULTS Bel7402/5-FU cells were resistant not only to 5-FU but also to multiple anticancer drugs. When treated with the same concentration of 5-FU (30 ?mol?L -1 or 150 ?mol?L -1 ), the proportion of apoptosis was significantly increased and G_0/G_1 phase was increased and S and G_2/M phases were reduced in Bel7402 cells, but the proportion of apoptosis and cell cycle was not changed in Bel7402/5-FU cells. The expression of bcl-xl, bcl-xs, and bax mRNA were significantly increased and the expression of p53 and cpp32 mRNA were significantly decreased in resistant Bel7402/5-FU cells, as compared with Bel7402 cells. CONCLUSION Decrease of apoptosis may be related to multidrug resistance of human hepatocellular carcinoma cells Bel7402/5-FU. The up-regulation of anti-apoptotic genes and down-regulation of pro-apoptotic genes are involved in the development of multidrug resistance in Bel7402/5-FU cells.

Hospitalization expenses constitute the main part of the compensation of medical insurance.The aim of this paper is to analyze the variation of medical expenses of hospitalized patients with medical insurance in different modes of accounting,find the influencing factors in accounting quotas on hospitalization expenses,and set up a scientific and reasonable mode of accounting with a full consideration of the huge demands of medical resources.

Objectives: To investigate the affecting factors on expenditure in Medical insurant inpatients. Methods: 593 medical insurant inpatients, who were from Feb 1, 2001 to Feb 31, 2002 in Nanjing Jinling hospital, were enrolled in this study. The inpatient expenditure was analyzed from the aspect of operation or not, age, and payment mode, used the descriptive analysis and multi factor analysis on affecting factors of the total expense, self bearing expense, and self affording expense. Results: The hospitalized days, operation or not, severity of disease were important affecting factors. The self bearing expense of medical insurant inpatients was associated with hospitalized days, operation or not, and total expense. While the self affording expense of them was associated with expense of drug, hospital bunk, radiation and others. Conclusions: We can control these associated affected factors to lighten the economic weight of patients, and to reduce the ratio of individual payment.

Objective: This study aimed to analyze the high medical expenses of hospitalized medical insurance patients for the first ten systemic diseases.Methods: We investigated the medical expenses for the first ten systemic diseases among 10 900 hospitalized medical insurance patients of a hospital,calculated the average expenses and total payment for the treatment of each of the systemic diseases that involved 5% of the total patients,computed their percentage in the total expenses,and compared them with those of all the other hospitalized cases.Results: The medical cost of the 5% of the first 10 hospitalized systemic diseases accounted for 21%-29.9% of the total expenses of all the hospitalized patients,4.3-6.0 times that of the average expenses,and 30.8%-54.9% paid by the patients themselves.In addition,the hospital stay of these patients was 1.5-4.7 times that of the average.Conclusion: The high medical expenses involving 5% of the hospitalized patients with the first 10 systemic diseases amounted to a quarter of those paid by all the hospitalized patients.Effective measures have to be taken to keep high hospitalization expenses at a reasonable level.

Object To research on genetic relationship among the main populations of Salvia miltiorrhiza Bge. and the genuineness of the herb. Methods From main distributed places, 44 samples (including nine populations) were analyzed by RAPD. The data of amplified bands were analyzed by the software NTSYS-pc and AMOVA. Results (1) From more than 100 primers, 11 primers producing polymorphism and reproduceable bands were selected, 129 bands were amplified. (2) The percentage of polymorphic bands within different populations were 20.9%-55.0%. (3) The cluster map including all samples were obtained by UPGMA. In the map, there were six cluster groups and three individuals outside the groups. The branch with five samples of Zhongjiang Sichuan population were far from other samples in genetic distance. (4) According to the distribution provinces five groups were divided in genetic variance analysis. Genetic variance 80.44% existing within population, 8.29% among populations and 11.27% among groups. Conclusion (1) The genetic diversity within population of S. miltiorrhiza is plentiful. (2) The seeds of the cultivated population in Shandong and Henan Provinces come from the wild ones of same places. The cultivated plants lack artificial selection. The decrease of chemical compound is mainly due to the undesired condition of cultivating. (3) The genetic differentiation among the populations from different provinces is unbalance. Two population from Zhongjiang Sichuan and Chengde Hebei are far from the other population. (4) The genuineness of Radix Salviae Miltiorrhizae should be decided according to modern evaluation system. The herbs from some places of Shandong and Henan should be genuine ones.

Objective The article was to analyze the payment structure of hospitalized urban employees receiving basic medi -cal insurance and the factors affecting the payment structure , resulting in measures to control the in-hospital fee of Medicare patients . Methods Statistical analysis was done on hospitalization expenses , expense composition and payment structure of hospitalized Medi-care patients in a first-class comprehensive hospital from 2002 to 2012 .The analysis of multiple stepwise regression were done on possi-ble influencing factors of hospitalization expenses and payment structure . Results With the adjustment of health policy , the propor-tion of medical insurance fund payment in the hospitalization expenses increased year by year , while the individual payment-scale re-duced accordingly .The hospitalization expenses and payment structure of Medicare patients were correlated with Medicare payment pol -icy, social demographic characteristics and clinical disease features . Conclusion By rational control on controllable factors , empha-sis on health care education , adjustment on Medicare payment policy and promotion on two way referral system , it is hopeful to realize the effective utilization of health resources , to achieve reasonable control on medical costs , and to reduce patients'economic burden .

Objective To observe the expression of Toll-like receptor(TLR) on peripheral blood dendritic cells(DC) in children with Henoch-Schtinlein purpura(HSP),and to investigate the pathogenesis of the abnormal expression of TLR in children with HSP.Methods Twenty hospitalized children with HSP in the Affiliated Hospital of Qingdao University Medical College from Dec.2011 to Jul.2012 were enrolled in the study(HSP group).Twenty agemetched healthy children were selected as a healthy control group.Peripheral venous blood was sampled under aseptic condition,peripheral blood mononuclear cells (PBMC) were isolated from density gradient centrifugation,and DC were generated by recombinat human granulocyte-macrophage colony-stimulating factor(GM-CSF),interleukin-4(IL-4) and tumor necrosis factor-α(TNF-α) in vitro.Expressions of CD83,CD86 and TLR2,TLR3,TLR4 in peripheral blood DC were examined by fluorescent activated cell sorter (FACS).Results 1.No significant distinction was found in the expression of the C Ds3 on peripheral blood DC between HSP group and healthy control group(t =0.80,P ＞ 0.05) ;in HSP group had remarkably increased expression of the CD86 on peripheral blood DC than that of the healthy control group (t =9.56,P ＜ 0.01).2.Expression rates of TLR2,TLR3,TLR4 on peripheral blood DC in the HSP group were higher than those in the healthy control group(t =1 1.79,13.29,9.45,all P ＜ 0.01).3.Expression rates of TLR2,TLR3 and TLR4 in HSP group had positive correlation with expression rates of CD86 (r =0.84,P ＜ 0.01 ; r =0.53,P ＜ 0.05 ; r =0.66,P ＜ 0.05).Conclusions Expressions of TLR2,TLR3 and TLR4 on peripheral blood DC significantly increased and were positively correlated with expression of CD86.This implies that TLR and co-stimulatory molecules might participate in the pathogenesis of HSP by mediating signal transduction,leading to abnormity of cytokines,then inducing Th1/Th2 immune imbalance by showing the advantage of Th2 function.

Objective To apply the Comprehensive Function Assessment for Disabled Children in family care for children with cerebral palsy. Methods From May, 2014 to May, 2015, 120 cerebral palsy children were equally divided into control group and observation group. The control group accepted routine rehabilitation, and the observation group accepted targeted family rehabilitation program based on the evaluation of Comprehensive Function Assessment for Disabled Children. They were assessed with Comprehensive Function Assessment for Disabled Children before and three months after rehabilitation. Results The scores of cognitive function, language function, exercise abil-ity, self-care movement and social adaptation ability improved in both groups after rehabilitation (t>2.498, P<0.05), and improved more in the observation group than in the control group (t>2.062, P<0.05). Conclusion The application of Comprehensive Function Assessment for Disabled Children may help to plan a targeted rehabilitation nursing program for the nurses and the parents, that benefits the rehabilitation for children with cerebral palsy.

Traditional Chinese medicine is an important part of Chinese traditional culture and has played an increasingly important role in the field of health care in recent years.Shandong Province,as a province with large resources of traditional Chinese medicine,has the natural advantages and deep foundation to develop traditional Chinese medicine health care industry.Based on Strengths,Weaknesses,Opportunities & Threats(SWOT)analysis,the advantages,disadvantages,opportunities and challenges of the development of traditional Chinese medicine health care industry in Shandong Province were deeply analyzed.SWOT matrix model was constructed to put forward targeted countermeasures and suggestions,in order to provide theoretical support and practical guidance for the healthy development of traditional Chinese medicine health care industry in Shandong Province.

Traditional Chinese medicine is an important part of Chinese traditional culture and has played an increasingly important role in the field of health care in recent years.Shandong Province,as a province with large resources of traditional Chinese medicine,has the natural advantages and deep foundation to develop traditional Chinese medicine health care industry.Based on Strengths,Weaknesses,Opportunities & Threats(SWOT)analysis,the advantages,disadvantages,opportunities and challenges of the development of traditional Chinese medicine health care industry in Shandong Province were deeply analyzed.SWOT matrix model was constructed to put forward targeted countermeasures and suggestions,in order to provide theoretical support and practical guidance for the healthy development of traditional Chinese medicine health care industry in Shandong Province.