As the major means of outpatient payment for basic medical insurance (the insurance for short) relies on fee-for-service, it tends to encourage unreasonable growth of medical expenses. Based on the principal-agent theory, this paper analyzed the principal-agent relationship between the insurance handling agencies and the hospitals designated by the insurance, and constructed a benefit game model of outpatient payment methods and the supporting supervision game model. This practice aims to explore the optimal and balanced benefit of the insurance payment methods and supporting supervision mechanism, and provide decision support for promoting the reform of medical insurance outpatient payment in China. The analysis results of the benefit game model of payment methods showed that a system mixing the post-payment and pre-payment could optimize and maximize the total benefits and interests of all the stakeholders within the system. Specifically, the practice recommended was a mixed payment integrating ambulatory-payment-classification, fee-for-service and global-budget-payment. The analysis of the supporting regulatory game model found that the factors that must be considered to ensure the expected utility of the above mixed payment mode as follows: the gap between the unreasonable income obtained by the hospital by out-of-control charging and the reward obtained by under-control charging, the size of the penalty after the unreasonable income of the hospital was discovered, the size of the regulatory cost and the loss of benefits of the government and the insured group. It is suggested to adopt the mixed payment method mainly based on the ambulatory-payment-classification supported by fee-for-service and global-budget. At the same time, medical insurance agencies can improve their supervision mechanism from such aspects as perfecting penalties, reducing supervision costs, leveraging government administrative power and advocating public supervision.

We presented an adolescent with recurrent intracranial hemorrhage and skin lesion. The diagnosis was unclear and the treatment was difficult. Through a multidisciplinary effort type Ⅰ interferon disease was suspected and later, an interferon-stimulated gene was further detected. Considering the high morbidity and fatality rate of recurrent intracranial hemorrhage, tofacitinib and hydroxychloroquine were administered. After treatment, the livedo reticularis was significantly regressed. Unfortunately, the intracranial hemorrhage recurred due to a pre-existing cerebral aneurysm, leading to death of the patient. The diagnosis and treatment of this case highlight the importance of multidisciplinary collaboration in the diagnosis and treatment of difficult and rare diseases.

OBJECTIVE: The design and development of split memory alloy sternum bone plate are discussed, and the effect of split memory alloy sternum bone plate internal fixation in the treatment of sternal fractures are analysed. METHODS: The structure of the product is designed according to the anatomy and physiological characteristics of human bones, and the cross section shape of the product is designed according to the cross section shape of human bones. Internal fixation is effective in the treatment of sternal fracture. RESULTS: The split memory alloy sternal plate was successfully designed and developed, and all the patients with sternal fractures treated by internal fixation were clinically healed, the hospitalization and fracture healing time were significantly shortened, and no obvious complications occurred. CONCLUSIONS The application of split memory alloy sternal plate internal fixation in the treatment of sternal fracture has the advantages of small trauma, simple operation, safety, reliable fixation, good histocompatibility and less complications, and is conducive to promoting fracture healing and respiratory function improvement.
Alloys ; Bone Plates ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Sternum/surgery*

After years of exploration, Central South University has comprehensively reformed and upgraded the curriculum in both horizontal and vertical integration, including optimizing and constructing a basic clinical core curriculum system with organ system integration as the main line, utilizing the advantages of comprehensive universities to further advance the cross-teaching reform of science, engineering, arts and medicine, strengthening pre-medical education with the goal of early exposure to medicine, promoting the reform of early contact clinical integrated teaching according to the concept of "early, multiple and repeated clinical practice", and accelerating the integration of clinical skills training courses with the support of clinical skills simulation teaching. After the integration, the faculty team has gradually matured and the teaching quality has been significantly improved, which has strengthened the students' medical thinking and overall literacy.

Medical simulation teaching is an emerging and developing teaching method in our coun-try. At present, the simulation teaching centers are developing rapidly in higher education institutions, but how to improve the effectiveness in the operation of the centers is still a subject that needs to be discussed. Based on our own experience, this paper analyzes the related factors in developing medical simulation teach-ing centers, making summary and demonstrations from aspects of team building, teacher training, docking needs, staffing and so on, so as to provide references and suggestions for the construction of medical simu-lation center higher education institutions.

Skeletal muscle possesses a remarkable ability for its regeneration and injured tissue repair. This ability depends on the activity and contributions of muscle satellite cells. Proliferating satellite cells, termed myogenic precursor cells or myoblasts, are activated and driven out of their quiescent state upon muscle injury. In this summary, we present a review to summarize the molecular regulation in skeletal satellite cells to light on the satellite cells' self-renewal mechanism.
Cell Proliferation ; Humans ; Muscle, Skeletal ; Regeneration ; Satellite Cells, Skeletal Muscle ; cytology ; Soft Tissue Injuries

Objective According to the infrared spectrum of renal stone composition analysis,discuss the relationship between gender,age and kidney stone.Methods Kidney stone composition analysis of 408 cases had been done in our hospital from the 2002 to 2011 by using Fourier transform infrared spectroscopy.There were 271 males (66.4％) and 137 females (33.6％).Results There were 359 cases with calcium stones,accounting for 88.0％ (359/408); 197 cases with calcium oxalate stones alone,accounting for 48.3％; 180 cases with phosphate stones,accounting for 44.1％; 211 cases with mixed composition stones,accounting for 51.7％.Main chemical composition of the stones were:calcium oxalate 48.3％,carbonate apatite 34.8％,urates 5.4％,ammonium magnesium phosphate 4.4％,ammonium carbonate eutectic 3.4％,brushite 1.5％,cystine 2.0％ and protein 0.3％.Male patients accounted for 66.4％ of all cases and the peak onset age was 30-59 years; Female patient accounted for 33.6％ of all cases and the peak onset age was 50-59 years.Conclusions Calcium oxalate and phosphate are the most common components of kidney stones.Males age between 30-59 years and females age between 50-59 years may suffer from of kidney stone formation.

After Human Gene Project, studying the kinetics of DNA translocation through a nanopore, and developing a novel fast DNA sequencing technology by using nanopore have become one of the hot in gene-research). This contribution provides an overview of nanopore macromolecular identification,including bionanopore and solid-state nanopore, while the perspective of these research are also summarized.

Embryonic stem (ES) cells have the unique capacity to proliferate extensively and maintain the potential to differentiate into advanced derivatives of all three primary germ layers. ES cell lines can also be generated from human blastocyst embryos and are considered promising donor sources for cell transplantation therapies for diseases such as juvenile diabetes, Parkinson's disease, and heart failure. However, as for organ transplants, tissue rejection remains a significant concern for ES cell transplantation. Another concern is the use of human embryos. One possible means to avoid these issues is by reprogramming the nuclei of differentiated cells to ES cell-like, pluripotent cells. This review discusses the potential of these strategies to generate tailor-made pluripotent stem cells and the role of transcription factors in the reprogramming process.
Cell Culture Techniques ; Cell Differentiation ; physiology ; Cells, Cultured ; Cellular Reprogramming ; Humans ; Nuclear Transfer Techniques ; Pluripotent Stem Cells ; cytology

Objective To study the effect of chemotherapeutic agents of different doses on sensitivity of glioma U251 cell line to chemotherapy.Methods The rates of cell growth of the U251 cell line under the effect of different chemotherapeutic agents(DOX、VCR、VP-16 and with verapamil)of a series of doses were detected by MTT assay.Results Using DOX or VCR or VP-16 singly,the rates of cell growth were detected at a lever with positively correlates with the concentrations of these chemotherapeutic agents.Moreover the rates of cell growth changed more obviously within some range of concentrations,while the change is limited with the high or low concentrations.The combination of pates of chemotherapeutic agents and verapamil show synergistic effect.Conclusions The relationship between the doses of chemotherapeutic agents and sensitivity of chemotherapy gas a basis for choosing appropriate clinical chemotherapy doses.