To discuss background of Medicare hospital payment system reform in the U.S., its legislative and administrative system and the key issues incurred during the design and implementation process, then summarized the experiences and lessons and suggestions were proposed for current provider payment reforms in China.

We collected the medical data of conscription physical examination from a certain county,Shandong Province,in August 2013.A cohort of 711 young males aged from 17 to 24 years were included.Among them,231 cases were diagnosed with varicocele (VC) with a prevalence of 32.49％ (231/ 711).Its grades were Ⅰ ° VC(n =5,2.2％),Ⅱ ° VC (n =165,71.4％) and Ⅲ° VC(n =54,23.4％).And 7 cases (3.0％) had surgical intervention.Our reported prevalence was significantly higher than that in the literature.Further researches are waranteed.

Objective To optimize the conditions for enhancing the refolding of a novel recombinant human(rh)endostatin and test the biological activities of refolded endostatin.Methods The partial purified inclusion bodies of rh-endostatin were dissolved with 6 mol/L guanidine-HCl followed by combination of dilution and dialysis of the dissolved endostatin.The refolded endostatin was then purified by cation-exchange chromatography.The biological activities of purified rh-endostatin were assessed by endostatin-specific monoclonal antibody and chick embryo chorioallantoic membrane assay.Results A 46% refolding yield was achieved after optimizing the refolding conditions.The purified endostatin reacted with specific anti-endostatin monoclonal antibody and showed significant inhibition of angiogenesis in chick embryo ehorioallantoic membrane assay.Conclusion The method of highest refolding yield of human endostatin was developed.This optimized method significantly promotes the application of this novel human endostatin to preclinical and clinical studies.

Xiaozhenjie (Miraculous Pivot Chapter 3: Annotation of Fine Needle) is the earliest annotation of Jiuzhen Shieryuan (Miraculous Pivot Chapter 1: Nine Needles and Twelve Yuan-Primary Acupoints). There are particularly 24 annotations of qi in the chapter. Based on the original literature, the styles of qi annotationsl were divided into three categories. By comparing with the original text, semantic features of qi annotations were reasoned. In reference to the understandings and notes of qi annotations given by the scholars of different dynasties, the origin of qi connotation in the ancient time was clarified so as to provide the historical evidence to the for-mation of this unique "qi language" and "qi worldview". It presents the instructive significance to understand and interpret "qi" for the scholars in the modern time.
Acupuncture Points ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Medicine, Chinese Traditional ; history ; Meridians ; Qi ; history

The accurate annotation of ashi points depends on the understanding of ashi. The main reasons for the divergence of current three viewpoints on the annotation of ashi are the literature basis and its different interpretations. By conducting a comprehensive collection of ancient and modern literature and analyzing different interpretation methods, the original meaning of ashi is studied, so as to explain the understanding of ashi points and ashi method.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Medicine in Literature

Objective To investigate the relationship between the doses of epidural morphine administered for postoperative analgesia and postoperative urinary retention (POUR). Methods Sixty ASA Ⅰ patients aged < 20-56 yr undergoing atthroscopic knee operation under epidural anesthesia were randomly divided into 3 groups ( n = 20 each) : group Ⅰ and Ⅱ received epidural morphine 1 and 3 mg in 5 ml of normal saline (NS) respectively at the end of operation (group M1, M2 ); group Ⅲ received NS 5 ml instead of morphine (group C). Urinary retention was defined as the patient could not void, when bladder volume was ≥ 600 ml measured using ultrasound. Bladder urine volume was measured before anesthesia and at 4, 6, 8, 10 and 12 h after operation. The occurrence of urinary retention, the first postoperative voiding time, VAS scores and the incidences of vomiting and pruritus were recorded. Results The 3 groups were comparable with respect to age, M/F sex ratio, preoperative bladder urine volume, the amount of local anesthetic used during operation and duration. The incidences of urinary retention, vomiting and pruritus were 65%, 60% and 90% respectively in group M2 and significantly higher than those in the other 2 groups. The first postoperative voiding time was significantly longer in group M2 than in the other 2 groups. VAS scores were significantly lower in group M1 and M2 than in group C. There was no significant difference in VAS scores between group M1 and M2. Conclusion Epidural morphine increases the incidence of POUR in a dose-dependent manner, and 1 mg is the recommended dose.

CD36 is involved not only in the metabolism of lipids,but also in the inflammatory reaction,in the formation of foam cells and in the pathogenesis of atherosclerosis.Monocyte/macrophage CD36 has been shown to play a critical role in the development of atherosclerotic lesions by its capacity to bind and en-docytose oxidized low density lipoproteins(oxLDL),and it is implicated in the formation of foam cells.CD36 expression and regulation mechanism already provides a new understanding and the relevant drug research has attracted more attention of scholars.This article is to carefully review the importance of CD36 as an essential component in the pathogenesis of atherosclerosis.

OBJECTIVE:To facilitate a high performance operation of drug supply chain so as to provide satisfactory service for patients,the common terminal customers.METHODS:The principle of customer demand driven in drug supply chain and the significance of customer demand driven in drug supply chain management as well as the role hospitals played in the practice of the customer demand driven-based drug supply chain management were analyzed and qualitatively described.RESULTS & CONCLUSIONS:In the environment of buyers' market of drugs,as the terminal customers' envoy plenipotentiary and the best valuable clients in the drug market,hospitals play a key role in back driving drug supply chain's high performance operation.

OBJECTIVE:To establish the quality standard of New Tongzhi surunjiang capsule. METHODS:Qualitative identification of Folium Sennae,Crocus sativus and Colchicum autumnale was conducted by TLC method. The content of gallic acid in the formulation was determined by HPLC. RESULTS:The TLC spots of Folium Sennae,Crocus sativus and Colchicum autumnale were clear and well-isolated. The linear range of gallic acid was 0.155 7～1.401 3 ?g(r=0.999 8) with a mean recovery rate of 101%(RSD=1.64%,n=9).CONCLUSION:The established standard is suitable for the quality control of New Tongzhi surunjiang capsule.