Reform of the medical service payment system plays a key role in deepening the ongoing health reform.China will launch in a large scale the trials of the payment system for its betterment.The author probed deeply into the current compensation mechanism of public hospitals,as well as the inherent and theoretical roots of the negative outcomes resulting from the item-based payment system.On such basis,the paper discussed the nature of the public hospitals,and the theoretical basis for public hospitals' compensation system.In addition,the author discussed the reform principles and key points for reforming the payment system amid the ongoing health reform,proposing to link this reform with resolving major setbacks of the compensation mechanism of public hospitals.Objectives for the medical service payment system reform are advocated as follows: Cost control,management enhancement,mechanism shift,and win-win,which aim to deep reforms of the public hospitals.

With the publish of National Medical Service Pricing Item Regulation(2012 edition), a new round of medical service items matching and pricing work across the country. Under the guidance of new pricing elements and pricing policy, to actively discuss on designing more scientific pricing method. Based on the field survey and qualitative interviews, several main pricing methods currently used in China were summarized to analyze the advantages and disadvantages of these methods.

Objective To investigate the effect of dexmedetomidine on liver function,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury in patients undergoing hepatolobectomy.Methods A total of 106 patients who underwent hepatolobectomy in General Hospital of Jizhong Energy Fengfeng Group Co.,Ltd.from January 2014 to January 2016 were enrolled and randomly divided into control group and observation group,with 53 patients in each group.The patients in the observation group were given 1 μg/kg/h dexmedetomidine within 10 minutes,followed by continuous intravenous infusion of 0.5 μg/kg/h dexmedetomidine,and those in the control group were given an equal volume of 0.9％ sodium chloride.The two groups were compared in terms of liver function parameters,plasma cytokine levels,and oxidative stress due to ischemia/reperfusion injury after anesthesia (T1),before abdominal closure (T2),and at 1,4,and 8 hours after surgery (T3,T4,and T5,respectively).The chi-square test was used for comparison of categorical data between groups;the t-test was used for comparison of indices between groups,the sphericity test was used for comparison of indices at different time points,and an analysis of variance was performed for repeated measurement data with P ＜ 0.05.Results The two groups had significantly higher alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at T2,T3,T4,and T5 than at T1 (ALT:F =43.72 and 44.16,both P ＜ 0.001;AST:F =53.87 and 65.44,both P ＜ 0.001),and the observation group had significantly lower levels than the control group atT2,T3,T4,andT5 (ALT:t =20.54,22.01,36.68,and 38.15,all P＜0.001;AST:t =32.27,41.08,52.82,and71.89,all P ＜ 0.001).The two groups had significantly higher levels of tumor necrosis factor α (TNFα) and interleukin-8 (IL-8) at T3,T4,and T5 than at T1 (TNFα:F =54.37 and 24.75,both P ＜ 0.001;IL-8:F =47.24 and 27.39,both P ＜ 0.001),and the observationgroup had significantly lower levels than the control group at T3,T4,and T5 (TNFα:t =59.39,86.32,and 83.16,all P ＜ 0.001;IL-8:t =74.47,72.29,and 76.67,all P ＜ 0.001).The two groups had a significantly higher level of malondialdehyde at T3,T4,and T5 than at T1 (F =37.65 and 17.44,both P ＜0.001),and the observation group had a significantly lower level than the control group at T3,T4,and T5 (t =17.35,19.11,and 24.12,all P ＜ 0.001).The two groups had a significantly lower level of superoxide dismutase at T3,T4,and T5 than at T1 (F =36.54 and 33.65,both P ＜0.001),and the observation group had a significantly higher level than the control group at T3,T4,and T5 (t =68.64,66.35,and 59.48,all P ＜0.001).Conclusion Dexmedetomidine can effectively inhibit liver injury,reduce the levels of cytokines,and alleviate ischemia/reperfusion injury in patients undergoing hepatectomy.

The per-diem payment is a unit packaged payment used for the medical cost of hospitalization. At present some areas in our country explored the per-diem payment in hospitalization and have received obvious effect. The experiences of different areas carrying out the per-diem payment in our country were compared to find the strengths and weaknesses, and provide references for other areas.

Through analyzing domestic medical service payment method and day surgery payment method in USA and Australia, combine the current domestic progress of day surgery and its main prevailing payment to explore the future day surgery payment system in China.

The Pricing and Payment Regulation on Chinese Diagnosis Related Groups (C-DRG) was designed by National Health Development Research Center,directly under the leadership of Department of Finance,NHFPC (formerly Dept.of Planning and Finance,Ministry of Health),which organized a large study group consisted of nearly 1 000 experts since 2010.It introduced the general design of C-DRG and the principles and main points of applying C-DRG system,which could be referenced by all countries in carrying out the pricing and payment reform system.

Objective To provide scientific basis for prevention of source water pollution and minimization of impacts of biological pollution on drinking water quality.Methods The source water and finished water were determined based on the National Sanitary Method for Determination of Drinking Water(GB5750-1985),the sanitary quality of source water was classified based on the National Standard for Environmental Quality of Surface Water(GHZB1-1999),the sanitary quality of finished water was evaluated based on the National Sanitary Standard for Drinking Water(GB5749-1985).Results 36.8% of the accidents of source water pollution were induced by biological pollution,which mainly occured in rivers and lakes. Conclusion The important countermeasures for the minimization of source water biological pollution were to improve the process of water treatment and to develop the deep water treatment for conventional water treatment.

Objective To evaluate the application of small dural window exposure strategy for removal of subdu-ral hematomas and decompressive craniectomy in patients with severe brain injury. Methods Eighty patients with an ad-mission Glasgow Coma Scale score of 8 or less were randomly divided into two groups:Routine craniectomy group (42 pa-tients) and small dural window exposure strategy group (38 patients). The clinical outcomes were compared between these two groups. Results The average quantity of blood transfusion (erythrocyte suspension)at 24 h was 2.85 ± 1.98 and 1.43±1.40 unit in the routine craniectomy group and small dural window exposure strategy group, respectively. The num-bers of the delayed intracranial hematomas, traumatic epileptic seizure as well as acute encephalomyelocele were 10, 12 as well as 9 in the routine craniectomy group and 2, 3 as well as 1 in the small dural window exposure strategy group. However, the time of operate duration and the incidence of cerebral infaction were not significantly different between two groups (P>0.05). After 6-month follow-up, there were 16 cases with favorable outcomes including 10 with good recov-ery and 6 with mild disability and 26 cases with unfavorable outcomes, including 7 with severe deficits, 6 with persistent vegetative status and 13 dead in the routine craniectomy group. In contrast, there were 23 cases with favorable outcomes including 12 good recovery and 11 mild disability and 15 cases with unfavorable outcome including 6 with severe deficits, 4 with persistent vegetative status and 5 dead in the small dural window exposure strategy (P﹤0.05). Conclusion small dural window exposure strategy is an excellent technique for the complete evacuation of the traumatic intracranial hemato-ma, especially those with massive intraoperative swelling .

OBJECTIVE: To establish headspace capillary gas chromatography for the content determination of residual solvents in letrozole, such as chloroform, ethanol, acetone, ethyl acetate, DMF and isopropanol. METHODS: Dissolved in dimethyl sulfoxide, chloroform, ethanol, acetone, ethyl acetate, DMF and isopropanol in letrozole were determined by headspace gas chromatography with HP-5 capillary gas chromatography. ECD was applied for chloroform, while FID was applied for the other residual solvents. RESULTS: The liner ranges of chloroform, ethanol, acetone, ethyl acetate, DMF and isopropanol were 1.028～10.28 mg?L-1(r=0.999 9), 94.68～946.8 mg?L-1 (r=0.999 7), 94.64～946.4 mg?L-1(r=0.999 7), 110.64～1 106.4 mg?L-1(r=0.999 7), 15.12～151.2 mg?L-1(r=0.999 6), 116.48～1 164.8 mg?L-1(r=0.999 5), respectively. The average recoveries of the residual organic solvents ranged from 97% to 102%. The detection limits were 20～90 ?g?L-1. The residual levels of the six organic solvents in three batches of samples were all up to the standard stipulated in Chinese Pharmacopeia. CONCLUSIONS: The method is simple, sensitive, accurate and reliable for the content determination of residual organic solvents in letrozole.

Objective To investigate the current application of teaching cadavers and attitudes of medical students towards body donation and anatomy practicum and to make proposals on teaching and learning of human anatomy.Methods A on the spot questionnaire survey among 300 students studying in Hebei Medical University was conducted and the acquired data were contrasted analyzed.Results The teaching cadavers were insufficient and the quality of anatomy education was directly affected.Medical students took unfavorable attitudes towards anatomy practice and knew little about body donation.The main factors affected body donations were traditional concepts,lack of humanistic concern and complicated procedures of donation.Conclusions The short of teaching cadavers would be relieved by enhancing propaganda and legislation,emphasizing humanistic concern,simplifying procedures of donation.By means of anatomy teaching reformations,the learning interest and humanistic literacy of medical students are supposed to be improved.