Antibacterial oxygenated ergostane-type steroids produced by the marine sponge-derived fungus Aspergillus sp.

Two oxygenated ergostane-type steroids including one new compound, 3ß-hydroxy-5α,6ß-methoxyergosta-7,22-dien-15-one (1) along with a known analogue ergosta-6,22-dien-3ß,5α,8α-triol (2) were isolated from the crude extracts of the marine sponge-derived fungus Aspergillus sp. Their structures were elucidated on the basis of combined NMR and MS spectroscopic methods. Compound 1 was a marine ergostane-type steroid with two methoxy groups at C-5 and C-6, respectively. These oxygenated ergostane-type steroids were evaluated for their antibacterial activities against human or aquatic pathogens. Among them, compound 1 exhibited antibacterial activity against Staphylococcus aureus.

Impacts of a new insurance benefit with capitated provider payment on healthcare utilization, expenditure and quality of medication prescribing in China.

OBJECTIVES: To assess a new Chinese insurance benefit with capitated provider payment for common diseases in outpatients. METHODS: Longitudinal health insurance claims data, health administrative data and primary care facility data were used to assess trajectories in outpatient visits, inpatient admissions, expenditure per common disease outpatient (CD/OP) visit and prescribing indicators over time. We conducted segmented regression analyses of interrupted time series data to measure changes in level and trend overtime, and cross-sectional comparisons against external standards. RESULTS: The number of total outpatient visits at 46 primary care facilities (on the CD/OP benefit as of July 2012) increased by 46 895 visits/month (P = 0.004, 95% CI: 15 795-77 994); the average number of CD/OP visits reached 1.84/year/enrollee in 2012; monthly inpatient admissions dropped from 6.4 (2009) to 4.3 (2012) per 1000 enrollees; the median total expenditure per CD/OP visit dropped by CNY 15.40 (P = 0.16, 95% CI: -36.95~6.15); injectable use dropped by 7.38% (P = 0.03, 95% CI: -14.08%~-0.68%); antibiotic use was not improved. CONCLUSIONS: Zhuhai's new CD/OP benefit with capitated provider payment has expanded access to primary care, which may have led to a reduction in expensive specialist inpatient services for CD/OP benefit enrollees. Cost awareness was likely raised, and rapidly growing expenditures were contained. Although having been partially improved, inappropriate prescribing of antibiotics and injectables was still prevalent. More explicit incentives and specific quality of care targets must be incorporated into the capitated provider payment to promote scientifically sound and cost-effective care and treatment.

Achieving universal health coverage-the case of Zhuhai city.

OBJECTIVE: Universal health coverage cannot be achieved without evidence from research, which requires national and international support. We hope that our careful documentation of one of China's local experience in designing and implementing the basic health insurance coverage, and our analysis of how it helped to achieve universal health coverage, will inform other systems in China as well as other relevant countries on their way to universal coverage. METHODS: The paper first presents the development of Zhuhai's basic health insurance system chronologically; then comprehensively describes the background and the key components of the common disease outpatient benefit package; followed by a comparison with the common practices of outpatient benefit package of other areas of China and four neighboring countries. It also summarizes the strengths and weakness of the package, and lists the remaining research questions for future studies. RESULTS: The common disease outpatient benefit package of Zhuhai has helped to improve the universal health coverage of Zhuhai in the following aspects: securing all citizens' access to the common disease outpatient services under the basic health insurance coverage; containing the rapid growth of health expenditures; enhancing provider awareness of expenditure and encouraging cost-effective interventions through appropriate financial incentives; and shifting the focus from treatment to prevention and preventing the development of common diseases into serious conditions with high cost specialist services. The common disease outpatient benefit package greatly improved and strengthened the basic health insurance system through secured equal access to affordable outpatient care for common conditions. CONCLUSION: Limited health resources are used more efficiently by pooling the risks and by implementing capitated provider payment, which enhances the cost awareness by health care providers, to improves efficiency and creates positive incentives for health professionals for using the most cost-effective health interventions.

The function of urine and hair fluorine in controlling of fluorosis / 中国地方病学杂志

Objective　To study the function of urine flu orine (UF) and hair fluorine (HF) in controlling of fluorosis.Methods　Villages that have approximately the same level of fluorine(F) in drinking water were chosen.UF and HF were measured in the villages.Results　The level of F in drinking water was highlyrel ated with UF but not with HF.UF and HF was not related.Statistical significantd ifferences of UF and HF were found between endemic and non-endemic,light and mid-severe areas.Conclusions　Both UF and HF can be used to determine end emic areas,especially in high Fenvironment.