Objective To identify the chief factors influencing health insurance patients' hospitali-zation expenses so as to provide basis for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods All the medical insurance cases involving the three disease entities in two hospitals of a certain city for the past three years, which totaled 647, were collected and a statistical analysis was made of the possible influencing factors using multi-stepwise regression analysis. Results The factors influencing the health insurance patients' hospitalization expenses included choice of hospitals, length of stay, performance of operations, proportion of drug fees, and province- wide readjustment of medical service prices. Reducing length of stay and lowering proportion of drug fees were the key to controlling expenses. Conclusion It is imperative to formulate scientific diagnostic and treatment routines and expense standards for single disease entities, speed up and deepen reform in the medical insurance system, and, on the basis of trying out payment based on certain single disease entities, implement payment based on disease entities.

Objective To examine the blood lead levels and influencing factors among infants living in urban areas in Taiyuan.Methods A total of 216 healthy infants living in urban areas in Taiyuan who came to seek routine care during 2010 and 2012 were enrolled using questionnaire survey.Blood samples were collected and lead was meas-ured according to standard procedures.Results The total blood lead level was (31.54 ±22.24)μg/L,there was no significant difference between male and female.The infants whose blood level was less than 50 μg/L took the biggest proportion(80.56%),the infants whose blood level was among 50 -99μg/L and whose blood level more than 100μg/L were 19.44% and 0.00% respectively.Coal to cook,mother often catching hair,using prickly heat,sucking on the hand,washing hands before meals,living in storefront and playing time in roadside were associated with infantile blood lead level.Conclusion The key influencing factors the of the blood lead levels of infants are infantile living environ-ment and the keeper's awareness of preventing lead.

Objective To investigate the status and influencing factors of breastfeeding among infants of 0 to 6 months in urban areas in Shanxi,to increase the rate of breastfeeding.Methods A total of urban infants aged 0 -6 months were selected and their mothers were investigated by the questionnaire on site.Results A total of 4 868 urban infants aged 0 -6 months and their mothers were investigated.The rate of breastfeeding was 64.60%,the rate of mixed feeding was 27.90%,the rate of artificial feeding was 7.40%.The infants′mother′s age,culture level, the way of delivery(natural labor,dystocia,cesarean delivery),the situation of the nipple(normal,flat,concave), nutritional status during pregnancy,mother's self awareness of the amount of breasts supply(enough,not enough)were associated with breastfeeding(χ2 =62.367,25.021,67.419,60.941,16.675,8.241,3.081,all P <0.05 or P <0.01).Conclusion The corresponding measures should be taken according to the factors affecting breastfeeding in order to improve the rate of breastfeeding.

Objective To evaluate the clinical efficacy and safety of high-dose Ambroxol in treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Retrieved from PubMed, EMbase, Cochrane Library, CNKI, VIP and WanFang databases by computer, randomized controlled trials (RCTs) about high-dose of Ambroxol in treatment of AECOPD were included. According to the inclusive and exclusive criteria, literatures and data were independently screened and extracted by two researchers, and the quality of the studies were assessed, Meta-analysis was conducted by RevMan 5.2 software. Results A total of 7 RCTs were included, involving 534 patients. Meta-analysis showed that experiment group can obviously improve the overall effective rate [OR = 4.11, 95%CI (2.31, 2.31), P < 0.000 01), shorten hospital stays(OR = 3.60, 95% CI (4.66, 2.55), P < 0.00001), compared with the control group was statistically difference, and no obvious adverse reactions. Conclusion High-dose of Ambroxol could improve AECOPD overall effective rate, shorten hospital stays, improve pulmonary function and blood gas analysis, and no serious adverse reactions, be worth clinical promote using.

Objective To search for the anticancer active substance from Caesalpinia sappan wood extractions. Methods Crude extracts were extracted from Caesalpinia sappan wood with different solvents.Liquid chromatography was applied to analyze the content of each essential component in the extraction fractions. Trypan blue exclusion test was performed to detect the growth suppression rate of human bladder carcinoma cell line T24 treated by the extraction fractions at different time course (20,40,60,80,100 min).The main component positively correlated with the cell suppression rate was separated out using repeated chromatography, thus the anticancer active monomer was obtained, with purity over 98 ％. The chemical constitution was determined using NMR (nuclear magnetic resonance), mass spectrum and infrared spectrum methods. T24 cell line, human ovarian cancer cell line SKOV3, mice sarcoma S180 and hepatic carcinoma H22 cell were chosen as target subjects, with mitomycin, hydroxycamptothecin as positive control drug, the inhibitory activity of the monomer was tested by trypan blue chromophobia method. Results Among the extraction fractions, R12 has a positive correlation with the cell suppression rate (r100 min=0.941, P＜0.001).Brazilin is the key component in R12.The inhibition rate of brazilin could reach 90.89 ％,98.65 ％,99.82 ％ and 100.00 ％ on T24,SKOV3,S180 and H22 respectively in 40 min at the concentration of 1.2 mg/ml,and its effect is much superior to that of the control drug mitomycin and hydroxycamptothecin. Conclusion Brazilin is one of the essential anticancer principles in Caesalpinia sappan wood.

OBJECTIVE:To systematically evaluate the efficacy and safety of cetuximab in the adjuvant chemotherapy treat-ment of advanced non-small cell lung cancer(NSCLC),and to provide evidence-based reference for clinical treatment. METH-ODS:Retrieved from Cochrane Library,PubMed,CJFD and Wanfang database,randomized controlled trials (RCT) about cetux-imab adjuvant chemotherapy (test group) versus single chemotherapy (control group) in the treatment of advanced NSCLC were collected,and Meta-analysis was performed by using Rev Man 5.2 statistical software after extracting data and evaluating quality. RESULTS:A total of 8 RCT were included,involving 2 367 patients. Results of Meta-analysis showed survival rate in 1 year [OR=1.33,95%CI(1.08,1.64),P=0.006],partial remission rate [OR=1.48,95%CI(1.23,1.78),P<0.001],total effective rate [OR=1.34,95%CI(1.19,1.51),P<0.001],incidence of leucopenia [OR=1.50,95%CI(1.23,1.83),P<0.001],incidence of rash [OR=53.26,95%CI(13.09,216.65),P<0.001] and incidence of infusion reactions [OR=3.72,95%CI(1.86,7.42),P<0.001] in test group were significantly higher than those of control group,there were significant differences in 2 groups. However,there were no significant differences in the complete remission rate [OR=1.57,95%CI(0.91,2.70),P=0.11] and incidences of other ADR(P>0.05). CONCLUSIONS:Cetuximab has good efficacy in the adjuvant chemotherapy treatment of advanced NSCLC,however,the incidence of ADR should be prevented in clinic. Duo to the methodology limit of included studies,large-scale and high quality RCT are required for further validation of the conclusions.

Objective To establish the nursing care for the patients with pulse steroid therapy, and to investigate its effect. Methods 78 patients who accepted pulse steroid therapy in the past 4 years were analyzed retrospectively, in which, 42 within past 2 years （2008 and 2007) were as pulse steroid nursing care group, and other 36 patients before 2 years (2007 and 2006) were as routine nursing care group. Results 3 weeks after the pulse steroid therapy, in pulse steroid nursing care group, proximal muscle weakness were found in 8 patents, insomnia in 18 patients; while in routine nursing care groups, proximal muscle weakness were found in 16 patents, and insomnia in 25 patients（P<0.05）. Conclusion Pulse steroid nursing care can reduce the incidence of muscle weakness and insomnia after pulse steroid therapy significantly.

Objective To evaluate the protective effect of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) against atopic dermatitis (AD) in Nc/Nga mice,and to explore its possible mechanism.Methods Sixteen Nc/Nga mice were classified into normal control group (n =4),low-concentration BCG-PSN group (n=5) and high-concentration BCG-PSN group (n =7) to be subcutaneously injected with sodium chloride physiological solution,BCG-PSN of 0.1 mg/kg and 0.5 mg/kg respectively,at 1,8,15 and 22 days of age.Dinitrochlorobenzene (DNCB) was repeatedly and topically applied to these Nc/Nga mice to induce AD-like lesions at 49 days of age.The preventive effect of BCG-PSN against AD was evaluated by dermatitis scores,scratching frequency,histopathological manifestations and immunological parameters (including IgE,i nterleukin (IL)-4 and-12,and interferon (IFN)-γ).Results Repeated injection of BCG-PSN within 4 weeks after birth significantly decreased the severity of DNCB-induced AD-like lesions,dermatitis scores and scratching behavior in Nc/Nga mice.There was no statistical difference in scratching frequency between the high-and low-concentration BCG-PSN groups.BCG-PSN treatment reduced the plasma level of IgE in Nc/Nga mice in a dose-dependent manner.BCG-PSN at 0.5 mg/kg increased the number of cells secreting IFN-γ in skin lesions of mice.Both doses of BCG-PSN down-regulated IL-4 level,but up-regulated IL-12 level in the culture supernatant of spleen mononuclear cells from mice.Conclusion Early injection of BCG-PSN could protect Nc/Nga mice against dermatitis by promoting the proliferation of IFN-γ-secreting cells,increasing the synthesis of IL-12,and reducing the levels of IL-4 and IgE.

Objective To establish a technical route for the efficient expression and purification of PprI protein from Deinococcus radiodurans R1 by using eukaryotic Pichia pastoris.Methods The encoding sequence of the Deinococcus radiodurans pprI gene was modified according to the preference of Pichia pastoris' codon.Modified pprI gene was fully synthesized with PCR and a 6 × His tag was added at its Nterminal.The PCR products were purified and then cloned into Pichia pastoris expression vector pHBM-905A.After utilizing Cop I and Not I double enzyme digestion and retrievering linear objective fragment,new pprI gene was transformed to the GS115 strain of Pichia pastoris.The obtained Pichia pastoris transformants were induced to express.Culture supernatants were detected by SDS-PAGE,Western blot,and mass spectrometry.A Ni-NTA column was uesd to purify the target protein and the BCA method was used to determine protein concentration.Results The coding sequence of new synthetic Deinococcus radiodurans pprI gene was correct.The purpose protein band of a molecular weight of 43 000 was detected in the culture supernatant of transformed Pichia pastoris strains by SDS-PAGE and Western blot.The mass spectrometry confirmed that it was the Deinococcus radiodurans PprI protein.When the concentration of imidazole was 250 mmol/L,the elution rate of PprI protein was the highest.The purified protein concentration was 0.35 mg/ml measured by BCA method.Conclusions This study has successfully constructed a new pprI gene and the recombinant strain of Pichia pastoris secreting PprI protein,and established a technical route for the efficient expression and purification of PprI protein.

Objective To construct the eukaryotic expression vector of pprI gene from Deinococcus radiodurans R1 and investigate its radioresistant effects in eukaryotic cells.Methods A recombinant vector pEGFP-c1-pprI was constructed by DNA recombinant technique.The empty vector pEGFP-c1 and the pEGFP-c1-pprI were transferred into human lung epithelial cells Beas-2B by LipofectamineTM 2000,respectively.Then the infected cells were screened in order to develop a cell line with stable expression of pprI gene.Cell survival rate was tested by clone-forming assay.Cell cycle distribution and apoptosis were detected by a flow cytometry.The fluorescence intensity of reactive oxygen species (ROS) was observed by a fluorescent microscope.γ-H2AX foci in the irradiated cell was detected by immunofluorescence.Results The eukaryotic expression plasmid of pprI prokaryotic gene was constructed and PprI fusion protein was expressed in human lung epithelial cells successfully,and the cell line (2BG) with a stable pprI gene expression was established.After irradiation,the cell survival fraction of 2BG cells was significantly higher than Beas-2B cells so that the value of D0 、Dq and N of the survival curve were increased.Moreover,the fluorescence intensity of ROS and the number of γ-H2AX foci in 2BG cells were also lower than those of B eas-2B cells(F =16.73,19.47,6.94,P ＜ 0.05).Between these two cell lines,the apoptosis rate and cell cycle G2 arrest also had significant difference (F =139.73,237.92,P ＜ 0.05).Conclusions The pprI gene from Deinococcus radiodurans RI can be stably expressed in the eukaryotic cells and it allows the transferred cells to have a radioresistant function.