OBJECTIVE:To study the implementation of scoring diseases payment under the control of total budget in some ar-eas of China,and provide reference for the further improvement of the payment. METHODS:Based on the operation process of scoring disease payment in the control of toal budget,the specific practices of Huaian,Nanchang,Zhongshan and Taiwan area, were compared. RESULTS:It showed differences in the control and allocation of total budget,the establishment of scoring diseas-es,the setup of adjustment coefficient,the development of balance methods,the complementary mechanism and the monitor exami-nation setting. CONCLUSIONS:Whether to classify the diseases according to diagnosis and treatment methods,how to setup ad-justment coefficient appropriately,how to reimburse the patients in stages and how to strengthen supervision are worthy of further thinking and exploring.

AIM: To investigate the expression of TNF-?, TGF-? in patients with oral lichen planus (OLP) and normal oral mucosa (NOM). METHODS: An immunohistochemical technique was performed to detect TNF-?, TGF-?_1 and TGF-?_2 expression in 22 cases with OLP and 10 normal controls. RESULTS: In lamina propria of OLP, the expression of TNF-? and TGF-?_1 were increased, whereas TGF-?_2 did changed significantly compared with control group. TNF-? positive signal were mostly found in macrophages, lymphocytes. TGF-?_1 positive cell was present in macrophages, endothelial cells and fibrocytes. CONCLUSION: TNF-? and TGF-?_1 play an important role in the development and maintenance of OLP local inflammation.

Objective: In order to evaluate the effect of catastrophic disease medical assistance policy in Qingdao and provide suggestions for Qingdao policy reform.Methods: This paper selects NSCLC and liver cancer as the typical deceases to analyze the effects of the policy on patients and medical insurance institutions and finally evaluate the effect of the policy.Results: results shows that after the implementation of special medicines and special medical equipment assistance, the rate of co-paying patients decreased 40.57%, and the pressure on medical insurance institutions' expenditure was significantly reduced;while after the implementation of large cost assistance, but rate of co-paying patients only decreased 7.13%, and the pressure on medical insurance institutions' expenditure was not effectively alleviated.Conclusions: Therefore, the policy not only protects patients with catastrophic disease by greatly reducing their medical burdens, but it also achieves the fine management of medical insurance fund and increases the efficiency of the fund.

Using the present cone beam reconstruction formula for general trajectory, we have investigated the issue of detector efficiency for non-helical trajectory. The results reveal that the two factors dominating the detector efficiency are detector geometry and filtering directions. The methods for to higher detector efficiency are proposed, and the reliability and feasibility are tested by simulation results.
Cone-Beam Computed Tomography ; instrumentation ; methods ; Humans ; Image Processing, Computer-Assisted ; methods ; Radiographic Image Enhancement ; methods ; Scattering, Radiation ; X-Ray Intensifying Screens

Objective To explore the clinical value of wave intensity(WI) curve of the carotid artery in patients with thyroid diseases and its value in evaluating cardiovascular function. Methods All 85 patients with thyroid diseases,including 45 hyperthyroidism and 40 hypothyroidism, were enrolled as case groups,while 270 healthy volunteers were considered as control. All the case groups and control were taken WI test under quiescent condition,and six continuous curves of the carotid artery diameter changes were recorded.Then the parameters of accelerating wave intensity (W1), decelerating wave intensity ( W2), negative area (NA) ,corrected R-W1 and W1-W2,elasticity modulus(Eρ) ,stiffness index(β) ,arterial compliance(AC) and pluse wave velocity(PWV) were calculated. Relationship between those indices and FT3 ,FT4 and TSH were analyzed by Pearson correlative analysis. Results The WI curve appeared differently among different groups,but the vessel elasticity indices did not have statistical significance. Correlation only existed between FT3 and part of the WI parameters. FT3 positively correlated with W1 ( r = 0. 951, P ＜0.01 ), NA( r =0.813, P ＜0.01) and W1-W2' ( r = 0. 887, P ＜0.01 ). And R-W1 ' negatively correlated with FT3( r =-0.878, P ＜0.01 ). Conclusions The WI curve could represent different function status of thyroid,and could be considered as a noninvasive examination for further clinical research,which may help explain the corresponding cardiovascular changes.

Objective To establish a high purity primary culture methods of human nasal epithelial cells (HNEC) in vitro and to provide a successful primary culture model for evaluation experiments of the nasal preparation .Methods Primary culture of human nasal epithelial cells were performed with enzymatic dissociation of isolated tissue and cultured in serum-free medium .HNEC were separated through magnetic field by immunomagnetic beads .We determined the purity of the separated cells by light microscopy and flow cytometry .The morphology of HNEC was observed with a scanning electron microscope .Results Under an inverted phase microscope ,the cells morphology was paving stone shaped .Under the scanning electron microscopy ,abundant microvilli and cilia differentiation were observed .Flow cytometry showed the epithelial cells accounted for 99% .Conclusion The highly purified HNEC can be directly isolated by the magnetic cell sorting system .The cell model can be used for the basic research of nasal cavity preparation .

Objective:To explore the effect of the virulence factor OatA during Staphylococcus aureus infection.Methods: In vitro,wild type of Staphylococcus aureus USA300,OatA gene deletion strain or OatA gene complemented strain were used to infect mice bone marrow divided macrophages (BMDMs).Subsequently BMDMs were separated and the case of cell death were detected.In vivo,mice pulmonary infection model was constructed with nasal inhalation of Staphylococcus aureus.Alveolar macrophages were isolated and the case of cell death were detected.Results: In contrast to wild type and OatA gene complemented strain,OatA gene deletion strain induced severer macrophage death both in vitro and in vivo.Conclusion: The virulence factor OatA inhibits Staphylococcus aureus infection-induced macrophage death.

Objective To summarize the characteristics of common carotid arterial wave intensity (WI) in healthy volunteers and offer the normal reference values of WI. Methods Common carotid arteries (CCA) in 525 healthy volunteers were examined using Aloka Prosound α10 equipped with wave intensity software. The volunteers were divided into six group according to age,group A,＜20 years old;group B,20 - 29 years old;group C,30 - 39 years old;group D,40 - 49 years old;group E,50 - 59 years old and group F,≥60 years old. Carotid arterial wave intensity in normal subjects had two positive peaks, the first peak,W1 ,and the second peak, W2. Between the two positive peaks, a negative area (NA), the time interval between the R-wave of ECG and the first peak(R-W1 ) and that between the first and second peaks (W1-W2) were observed. Results ① 1050 common carotid arteries in 525 volunteers were studied. The mean values of W1,W2,NA,R-W1,and W1-W2 were (8332±4796) mmHg · m-1 · s-3,(1853±1143)mmHg · m-1 · s-3,(38 ± 26) mmHg · m-1 · s-2, (102 ± 19)ms and (266 ± 42)ms,respectively. ②These values were no significant between the left and right CCA in same group. W1 and NA were correlated with age ( r = - 0. 204 and r = -0.301, P ＜0. 001). W1 and NA in group A and B were significant increased than those in other groups( P ＜0. 05 or P ＜0. 001 ). ③There were statistical significances in W1 and W1-W2 of CCA between male and female. ④There were no statistical significances in all values in common carotid arteries of both sides (P ＞0. 05). ConclusionsWI technique is useful for evaluating the dynamic behavior of the heart and the vascular system and their interaction. W1 is very sensitive to the changes in the working condition of the cardiovascular system.

Objective: To investigate the etiology, clinical features, treatment and outcome of nephrotic syndrome associated with chronic mercury poisoning. Methods: From June 2013 to April 2018, Beijing Chaoyang Hospital, Capital Medical University received 33 patients with chronic mercury-neutral nephrotic syndrome. The clinical manifestations, laboratory tests, treatment methods, and outcomes were analyzed. Results: Among the 33 patients, 27 patients had mercury exposure due to daily-life contact and the other 6 patients were caused by iatrogenic mercury. The symptom was characterized by typical nephrotic syndrome such as lower extremity edema and proteinuria at first onset. The treatment was based on mercury-removing treatment, 19 cases were treated with mercury removal alone, 16 cases were completely relieved; 10 cases were treated with mercury removal and glucocorticoids, all of which were completely relieved; 4 cases were treated with mercury removal, glucocorticoids and immunosuppressive agents, all complete remission; clinical complete remission rate is about 90.9% (30 cases in total) . Urinary mercury levels decreased the fastest between the first and second courses of mercury treatment, but the total amount of urine protein increased. As the amount of urinary mercury excreted increased, the total amount of urine protein decreased gradually (Z=2.86, P<0.01) . Conclusion The clinical features of chronic mercury-induced nephrotic syndrome are non-specific, easy to be misdiagnosed and missed. The treatment is mainly treated with mercury removal treatment. The prognosis is good. In severe cases, glucocorticoid therapy can be supplemented.

Objective:To observe the protective effect of Zhicao Tea Mixture on Müller cells and the expression of inflammatory factors in mice with diabetic retinopathy.Methods:Seventy-five C57BL/6J mice were randomly divided into the normal control group, diabetes mellitus (DM) group, low concentrations group, medium concentrations group and high concentrations group, with 16 mice in each group. The diabetes model of mice in all groups except the normal control group were established by intraperitoneal injection of STZ (60 mg/kg). Four weeks after the successful modeling, the Zhicao Tea Mixture with low (30 ml/kg), medium (60 ml/kg) and high concentrations (120 ml/kg) were respectively administered by gavage. Weight and blood glucose of mice in each group were measured every two weeks. After 8 weeks, Western blot method was used to detect the mice retina Müller cells activation marker gelatinous fibrous acidic protein (GFAP). Immunofluorescence was performed to detect the expression GFAP and glutamine synthetase (GS). Real-time quantitative PCR (RT- qPCR) and ELISA were used to determine the mRNA and protein expression levels of mouse retinal VEGF, TNF-α, IL-1β and IL-6 respectively.Results:The weight of mice in the DM group was lower than that of the normal control group, and the blood glucose was increased. Zhicao Tea Mixture had no effect on the weight of DM mice, but had a significant hypoglycemic effect. The GFAP expression ( t=38.318, P<0.001) in the retina of mice in the DM group was increased and GS expression ( t=29.737, P<0.001) was decreased compared with the control group. The GFAP expression ( t=13.677, 19.387, 16.305; P<0.05) in the retina of mice in the low, medium and high concentrations group were decreased and GS expression ( t=5.170, 19.399, 6.705; P<0.05) were increased compared with the DM group. The expressions of retinal inflammatory factors VEGF, TNF-α, IL-1β and IL-6 in DM group all increased, while the expressions of the above-mentioned inflammatory factors in the retina of mice decreased in the low, medium and high concentrations group. Conclusion:Zhicao Tea Mixture can decrease the blood glucose of DM mice and reduces the diabetic retinal inflammatory response.