Whether tiered medical care system is effective in saving costs?Cost savings estimation of the medical care system after tiered optimization in Zhejiang Province based on system dynamics model / 中国卫生政策研究

The experience of various countries proves that the hierarchical diagnosis and treatment model can lead to reasonable resources allocation and utilization, however, the waste of China''s disordered treatment model has not been estimated.Nowadays, it is very important to establish a hierarchical diagnosis and treatment system during China''s healthcare system reform.Therefore, it is necessary to estimate the benefit the reform may bring.We take Zhejiang Province as an example, and adopted the system dynamics model to build the health delivery system, to emulate the hierarchical diagnosis and treatment model and the disordered model, and to evaluate the benefit.Results showed that if first option at the primary health institutions increased 10%, it could save 0.251 billion yuan, and if increased 15%, it could save 0.39 billion yuan.If the first option at the primary health institution reached 72.35% and the treatment in county reached 90%, the outpatient in tertiary hospital could reduce by 13 million, and those in primary healthcare institutions could increase by 74 million yuan.The direct healthcare cost could reduce 3.016 billion Yuan.

Evidence-based research on the selection method system for China's essential medicine list / 中华医院管理杂志

Objective To find a selection method system appropriate for China's essential drug list.Methods Collection and analysis of technical paper literature on essential drug list developement,adjustment technical papers,and literature on evidence-based medicine,pharmacoeconomics evaluation,and medical insurance budget analysis from WHO and other countries.On such basis,a method system for selecting China's essential medicine list can be proposed,with its feasibility analyzed and demonstrated.Results The GRADE assessment proposed by WHO was used to evaluate the efficacy and safety of the drug;the pharmacy economics evaluation is added to assess the economic efficiency;these were aided by the pharmacoeconomics evaluation for a comprehensive evaluation of the pharmacoeconomics of the drug in question,supplementing analysis of the medical insurance,and ensuring its affordability of essential medicine so selected.The theory of this system is well developed,and supporting software ready for application.Examples in Zhejiang Province regarding essential medicine for diabetes have proved this method feasible.Data acquisition constitutes a major roadblock for scientific selection due to barriers against medical insurance data sharing.Conclusions Theoretic basis and method tools are fully available for essential medicine selection,and the selection method system as proposed in this study prove feasible to some extent.Decision makers are recommended to scientifically select the essential drugs,and to encourage data sharing,in order to make the list more scientific and pragmatic.

Toxic effect of exotoxin A of Pseudomonas aeruginosa on keratocytes / 吉林大学学报(医学版)

Objective To study the toxic effect of exotoxin A of Pseudomonas aeruginosa on keratocytes.Methods Three-dimensional gels of type I collagen containing rabbit keratocytes were incubated in the presence of different concentrations of exotoxin A(0.1,1.0,10 mg?L-1),cultivated for 24 h at 37℃,the change of keratocytes in morphology was observed under the light microscope,and the amount of lactate dehydrogenase(LDH) was measured by enzyme linked immunosorbent assay(ELISA).Results The LDH contents in different concentrations(0.1,1.0,10 mg?L-1)of exotoxin A groups were higher than that in the group without exotoxin A(P

Expression, purification and diagnostic application of EBV TK kinase / 中华实验和临床病毒学杂志

<p><b>BACKGROUND</b>To find a rapid and sensitive method for early diagnosis of nasopharyngeal carcinoma by using EBV TK kinase.</p><p><b>METHODS</b>Prokaryotic expression plasmid pRSETTK was constructed. EBV TK kinase was highly expressed in E.coil BL21 (DE3). The authors identified specificity of TK kinase by Western blot, then used purified TK kinase in ELISA to detect the IgG antibody in the serum of NPC patients.</p><p><b>RESULTS</b>Specific IgG antibody against TK kinase was found in the serum of NPC patients. The specificity and sensitivity of TK kinase were both 100% in Western blot and were 98.0% and 93.4% respectively in ELISA.</p><p><b>CONCLUSIONS</b>The EBV TK kinase showed high specificity and sensitivity in ELISA, therefore it can be used for early diagnosis of NPC</p>