Policy framework of the compensation mechanism reform for primary medical and health institutions in Zhejiang province / 中华医院管理杂志

Based on an analysis of the compensation policy and its problems of the primary medical and health institutions, this paper put forward the corresponding reform framework in Zhejiang province. It proposed to change the compensation policy of " predefining revenue and expenditure, subsidizing its gap after performance appraisal" into " a mixed system of special subsidy and pay for performance". Related policies were also described including governmental functions, special subsidies for input-based payments, classified payments for output services, precautions against financial risks, etc. This paper also suggested that we focus on dealing with the six pairs of balance, such as that between subsidy for the supply and demand sides, and that between internal market and external market.

The influencing factors of duration of untreated psychosis and the relationship between DUP and treatment outcome in epidemiological first episode schizophrenia / 中华行为医学与脑科学杂志

Objective To explore the influencing factor of duration of untreated psychosis(DUP) and the relationship between duration of untreated psychosis and treatment outcome in epidemiological first-episode schizophrenia. Methods 912 medical records of the first episode schizophrenia patients were recruited in the study for epidemiological survey . The general medical data, clinical diagnosis, and treatment outcome were collected. DUP was determined refer to symptom onset for schizophrenia (SOS) scale. Patients were divided into short DUP and long DUP groups according to the median values of DUP values. Results Between short DUP and long DUP groups, the difference in marriage was significant ( P < 0. 05). The unmarried patients in the short DUP group (63.7% ) was higher than the long DUP group (52.6% ), the variance was significant (λ2 =5.990, P<0.05). The divorce in the short DUP group (0.6% ) was lower than the long DUP group (4.4% ) , the variance was significant (λ2 =5.079, P<0.01).The simple schizophrenia in the short DUP group (1.5%) was lower than the long DUP group (4. 1% ) , the variance was significant (λ2 =5.868, P<0.05). The treatment outcomes between the two groups had a significant variance ( λ2 =36.093, P < 0.01) , and the Ridit analysis of treatment outcomes between the two groups showed significant difference ( u = 5.183, P<0.01). The marriage,age of onset and clinical diagnosis were significantly correlated with DUP in multiple factor Logistic regression analysis. Conclusion The marriage,age of onset and clinical diagnosis are significantly correlated with DUP in the first episode schizophrenia patients,the longer of DUP and the worse of treatment outcome.

Effects of maternal rats exposed to chronic unpredictable stress before pregnancy on the behaviors and brain monamine of their adult male offspring / 中华行为医学与脑科学杂志

Objective To examine the effects of maternal rats exposed to chronic unpredictable stress before pregnancy on the behaviors and brain monamine of their adult male offspring.Methods Sixteen SD rats were divided into chronic unpredictable stress (CUS) group and controls.CUS rats were exposed to 21 days chronic unpredictable stressors ,and the controls were stress-free.Ten days after the last stressor, all the female rats were caged with sexually experienced males of the same strain.Then we performed the following experiments on the two months male progeny, sucrose consumption measuring anhedonia, Morris water maze measuring cognitive function and high performance liquid chromatography detecting the contents of monoamine.Results The sucrose consumption showed that both sucrose intake and sucrose consumption percentage of the control progeny were higher than those of the CUS progeny ( sucrose consumption: ( 10.23 ± 4.12 ) g vs ( 6.48 ± 3.19 ) g; sucrose consumption percentage: ( 85.43 ± 20.15 ) % vs (60.98 ± 24.65 ) % ) (P ＜ 0.05 ).The number of times crossing the removed hidden platform in the CUS progeny ( 1.64 ± 1.69) was significantly fewer than that in the control progeny (4.17±2.29 ) in Morris water maze (P ＜ 0.05 ).The contents of serotonin in the hypothalamus of CUS progeny ( ( 500.17 ± 80.94 ) ng/g tissue) was lower than that of the control progeny ( ( 569.63 ± 50.91 ) ng/g tissue) (P ＜0.05) ,while the norepinephrine in the hippocampus of CUS progeny( (2315.01 ± 1397.12) ng/g tissue) was higher than that of the control progeny( (907.56 ± 207.27) ng/g tissue) (P＜0.05) by high performance liquid chromatography.Conclusions Depression or stressful events before pregnancy of dams result in anhedonia, decreased spatial memory and abnormalities in brain monoamine of their adult male progeny.