Clinicians are enthusiastically involved in etiologic research since they are paying more attention to the effect of etiology in management of disease in recent decades.However,there is a lack of understanding of the etiological view and etiologic research methods of clinical medical field.This article briefly introduces the etiologic concept,classification and research framework in epidemiology,in order to help clinicians to form a more integrated top-level design before the etiologic research.

Objective To investigate the inhibitory effect of favipiravir (T-705) on canine distemper virus (CDV) replication in Vero cells and DH82 cells.Methods The growth curves of CDV-11 strains from canine and CDV-3 strains from mink in Vero cells and DH82 cells were determined with indirect immunofluorescence assay and 50％ endpoint titration.The viability of Vero and DH82 cells was determined using the Cell Counting Kit-8.CDV inhibition at different concentrations of T-705 at different time points was measured .Results Cytotoxicity data showed that there was a moderate decline of viability in Vero cells after T-705 treatment, but no apparent cytotoxicity in DH 82 cells.T-705 significantly inhibited the replication of CDV-3 and CDV-11 in both Vero cells and DH82 cells in the test range of 2.441-1250 μg/ml. T-705 exhibited effective and stable antiviral activity when given at different time points post virus challenge .Conclusion Our results demonstrate that T-705 has effective antiviral activity and may be a promising anti-CDV drug candidate .

Comprehensiveness of care is one of the core attributes of primary health care, and it has a great impact on the first diagnosis,accessibility,coordination and continuity to form the primary health care high perform-ance mechanism. Comprehensiveness of care has been playing an increasingly significant role in case when faced with the challenges of the aging of Chinese population,the high prevalence of chronic diseases,and the rapidly rising cost of health care. It is a fundamental problem for researchers,policy makers,and practitioners to clarify the definition of comprehensiveness of primary health care,which is the basis for managing comprehensive services. This article has systematically reviewed the current researches on definitions of comprehensiveness of basic health care, ascertained the key elements of comprehensiveness,and pinpointed the relationship between the dominant and recessive elements. Then,it defined the conception and the boundary of comprehensiveness of care in the context of primary health care,ac-cording to three principles-controllability, exhaustion, and exclusiveness, and finally conceptualized the primary health care comprehensiveness for further study on the operational definition of primary health care attributes.

Objective:To observe the role of neuroinflammation in cognitive dysfunction induced by 1-bromopropane (1-BP) in rats.Methods:Male Wistar rats were randomly divided into control group, 1-BP group, pyrrolidine dithiocarbamate(PDTC)+ 1-BP group and PDTC group, with 15 rats in each group. Rats in 1-BP group and PDTC+ 1-BP group were given 800 mg / kg 1-BP by gavage, and rats in control group and PDTC group were given equal volume corn oil once a day for 12 days; rats in PDTC group and PDTC+ 1-BP group were intraperitoneally injected with 100 mg / kg PDTC 30 minutes after gavage, while rats in control group and 1-BP group were injected with equal volume of normal saline once a day for 12 days.From the 7th to 12th day of the experiment, ten rats in each group were randomly selected and subjected to Morris water maze test for detect the cognitive function. In the positioning navigation test, the learning ability of rats was evaluated by the escape latency and total swimming distance respectively. In the space exploration experiment, the memory ability of experimental animals was evaluated by the number of times crossing the target platform. After the experiment, ten rats were sacrificed, the cerebral prefrontal cortex was harvested. The cytosolic and nuclear NF-κB expression and phosphorylation were detected by Western blot, the mRNA levels of TNF-α and IL-1β were detected by qRT-PCR. After cardiac perfusion fixation, the brains of 5 rats were taken to make frozen sections for immunohistochemical staining and Nissl staining. SPSS 20.0 software was used for statistical analysis, repetitive measurement deviation analysis was used for the analysis of the swimming distance and the escape latency in positioning navigation test, One-way ANOVA was used for the analysis of the number of times crossed the target platform in spatial probe test and other data. Tukey's test was used for Post hoc comparison.Results:The results of Morris water maze showed that there was significant interaction between group and training time in the total swimming distance of rats in the four groups ( F=3.762, P<0.05). Simple effect analysis showed that the total swimming distance of 1-BP group in 1-4 days were longer than those of control group (all P<0.05), while the total swimming distance of PDTC+ 1-BP group in 1-4 days were shorter than those of 1-BP group (all P<0.05). There was significant interaction between group and training time in the escape latency among the four groups ( F=6.541, P<0.01). The escape latencies of 1-BP group in 1-4 days were longer than those of control group (all P<0.05), while the escape latencies of PDTC+ 1-BP group in 1-4 days were shorter than those of 1-BP group (all P<0.05). The results of space exploration experiment showed that there was significant difference in the number of crossing the platform among the four groups ( F=75.333, P<0.01). The number of crossing the platform (1.08±0.29) in 1-BP group was lower than that in the control (3.35±0.05) ( P<0.01). The number of crossing the platform (1.95±0.26) in PDTC+ 1-BP group was higher than that in 1-BP group ( P<0.01). It had significant difference both in the cytoplasm and in the nucleus of the NF-κB protein level in prefrontal cortex among rats of the four groups ( F=20.865, 23.877, both P<0.01). The levels of NF-κB in cytoplasm and nucleus of rats in 1-BP group were both higher than those in control group (cytoplasm: (177.3±32.1)%, (100.0±8.4)%, P<0.01; nucleus: ( 173.2±27.1)%, (100.0±8.4)%, P<0.01). While the levels of NF-κB in cytoplasm and nucleus of 1-BP+ PDTC group were both lower than those of 1-BP group (cytoplasm: (148.7±22.0)%, (177.3±32.1)%, P<0.01; nucleus: (149.7±18.8)%, (173.2±27.1)%, P<0.01). The results of qRT-PCR showed that there were significant differences in the mRNA levels of TNF-α and IL-1β in the prefrontal cortex among the four groups ( F=17.464, 17.382, both P<0.01). The levels of TNF-α and IL-1β mRNA in 1-BP group were higher than those in control group (both P<0.05), and the levels of TNF-α and IL-1β mRNA in PDTC+ 1-BP group were both lower than those in 1-BP group (both P<0.05). The results of immunohistochemistry showed that compared with the control group, the number of microglia and astrocytes in the 1-BP group increased (microglia: (158.30±9.68), (110.20±16.30), P<0.05; astrocytes: (122.76±4.35), (80.24±6.96), P<0.05), and the morphology was also activated, with light staining and reduced number of Nissl bodies in neurons.The number of microglia and astrocytes in PDTC + 1-BP group was lower than that in 1-BP group (microglia: (131.70±14.67), (158.30±9.68), P<0.05; astrocytes: (101.54±4.55), (122.76±4.35), P<0.05), and the Nissl body staining of neurons was significantly deepened. Conclusion:NF-κB signaling pathway might be the key mechanism of 1-BP neurotoxicity. PDTC intervention could significantly improve the neuroinflammatory response and behavioral disorders of experimental animals intoxicated with 1-BP.

Objective Explore the relationship between hospital characteristics and medical costs and length of stay,and thus provide policy recommendations for promoting the system of stroke classification and treatment.Methods Social Network Analysis methods were employed to explore the characteristics of medical institutions in stroke referral network,with multiple linear regression analysis used to explore the impact of network structure metrics on patients'length of stay,total hospitalization costs,and out-of-pocket expenses.Results A total of 11 918 stroke inpatients and 158 hospitals were included in the initial network.As the network threshold increases,the average length of stay per admission decreased from 15.76 days to 15.60 days,the average total hospitalization cost per admission decreased from 12 570.57 yuan to 1 1 897.40 yuan;and the average out-of-pocket cost per admission decreased from 1 745.66 yuan to 1 558.91 yuan.In the network with a threshold of 16,patients were referred a total of 89 740 times,with tertiary hospitals having the highest number of referrals(23 485 times for referral out and 21 371 times for referral in).Tertiary hospitals had the highest proportion of hospitals and centrality metrics in the referral network,except for degree centrality in the densest network.Higher centrality was associated with lower total hospitalization costs and out-of-pocket expenses,while higher closeness centrality was associated with shorter length of stay.Conclusion Tertiary hospitals occupied a dominant position in the stroke referral network.Secondary hospitals did not play an intermediary role in the system of stroke classification and treatment.Increasing the closeness of the referral network and forming closer and faster cooperation between medical institutions is beneficial to lower medical costs and length of stay.

Objective Explore the relationship between hospital characteristics and medical costs and length of stay,and thus provide policy recommendations for promoting the system of stroke classification and treatment.Methods Social Network Analysis methods were employed to explore the characteristics of medical institutions in stroke referral network,with multiple linear regression analysis used to explore the impact of network structure metrics on patients'length of stay,total hospitalization costs,and out-of-pocket expenses.Results A total of 11 918 stroke inpatients and 158 hospitals were included in the initial network.As the network threshold increases,the average length of stay per admission decreased from 15.76 days to 15.60 days,the average total hospitalization cost per admission decreased from 12 570.57 yuan to 1 1 897.40 yuan;and the average out-of-pocket cost per admission decreased from 1 745.66 yuan to 1 558.91 yuan.In the network with a threshold of 16,patients were referred a total of 89 740 times,with tertiary hospitals having the highest number of referrals(23 485 times for referral out and 21 371 times for referral in).Tertiary hospitals had the highest proportion of hospitals and centrality metrics in the referral network,except for degree centrality in the densest network.Higher centrality was associated with lower total hospitalization costs and out-of-pocket expenses,while higher closeness centrality was associated with shorter length of stay.Conclusion Tertiary hospitals occupied a dominant position in the stroke referral network.Secondary hospitals did not play an intermediary role in the system of stroke classification and treatment.Increasing the closeness of the referral network and forming closer and faster cooperation between medical institutions is beneficial to lower medical costs and length of stay.

Objective Explore the relationship between hospital characteristics and medical costs and length of stay,and thus provide policy recommendations for promoting the system of stroke classification and treatment.Methods Social Network Analysis methods were employed to explore the characteristics of medical institutions in stroke referral network,with multiple linear regression analysis used to explore the impact of network structure metrics on patients'length of stay,total hospitalization costs,and out-of-pocket expenses.Results A total of 11 918 stroke inpatients and 158 hospitals were included in the initial network.As the network threshold increases,the average length of stay per admission decreased from 15.76 days to 15.60 days,the average total hospitalization cost per admission decreased from 12 570.57 yuan to 1 1 897.40 yuan;and the average out-of-pocket cost per admission decreased from 1 745.66 yuan to 1 558.91 yuan.In the network with a threshold of 16,patients were referred a total of 89 740 times,with tertiary hospitals having the highest number of referrals(23 485 times for referral out and 21 371 times for referral in).Tertiary hospitals had the highest proportion of hospitals and centrality metrics in the referral network,except for degree centrality in the densest network.Higher centrality was associated with lower total hospitalization costs and out-of-pocket expenses,while higher closeness centrality was associated with shorter length of stay.Conclusion Tertiary hospitals occupied a dominant position in the stroke referral network.Secondary hospitals did not play an intermediary role in the system of stroke classification and treatment.Increasing the closeness of the referral network and forming closer and faster cooperation between medical institutions is beneficial to lower medical costs and length of stay.

Objective Explore the relationship between hospital characteristics and medical costs and length of stay,and thus provide policy recommendations for promoting the system of stroke classification and treatment.Methods Social Network Analysis methods were employed to explore the characteristics of medical institutions in stroke referral network,with multiple linear regression analysis used to explore the impact of network structure metrics on patients'length of stay,total hospitalization costs,and out-of-pocket expenses.Results A total of 11 918 stroke inpatients and 158 hospitals were included in the initial network.As the network threshold increases,the average length of stay per admission decreased from 15.76 days to 15.60 days,the average total hospitalization cost per admission decreased from 12 570.57 yuan to 1 1 897.40 yuan;and the average out-of-pocket cost per admission decreased from 1 745.66 yuan to 1 558.91 yuan.In the network with a threshold of 16,patients were referred a total of 89 740 times,with tertiary hospitals having the highest number of referrals(23 485 times for referral out and 21 371 times for referral in).Tertiary hospitals had the highest proportion of hospitals and centrality metrics in the referral network,except for degree centrality in the densest network.Higher centrality was associated with lower total hospitalization costs and out-of-pocket expenses,while higher closeness centrality was associated with shorter length of stay.Conclusion Tertiary hospitals occupied a dominant position in the stroke referral network.Secondary hospitals did not play an intermediary role in the system of stroke classification and treatment.Increasing the closeness of the referral network and forming closer and faster cooperation between medical institutions is beneficial to lower medical costs and length of stay.

Objective Explore the relationship between hospital characteristics and medical costs and length of stay,and thus provide policy recommendations for promoting the system of stroke classification and treatment.Methods Social Network Analysis methods were employed to explore the characteristics of medical institutions in stroke referral network,with multiple linear regression analysis used to explore the impact of network structure metrics on patients'length of stay,total hospitalization costs,and out-of-pocket expenses.Results A total of 11 918 stroke inpatients and 158 hospitals were included in the initial network.As the network threshold increases,the average length of stay per admission decreased from 15.76 days to 15.60 days,the average total hospitalization cost per admission decreased from 12 570.57 yuan to 1 1 897.40 yuan;and the average out-of-pocket cost per admission decreased from 1 745.66 yuan to 1 558.91 yuan.In the network with a threshold of 16,patients were referred a total of 89 740 times,with tertiary hospitals having the highest number of referrals(23 485 times for referral out and 21 371 times for referral in).Tertiary hospitals had the highest proportion of hospitals and centrality metrics in the referral network,except for degree centrality in the densest network.Higher centrality was associated with lower total hospitalization costs and out-of-pocket expenses,while higher closeness centrality was associated with shorter length of stay.Conclusion Tertiary hospitals occupied a dominant position in the stroke referral network.Secondary hospitals did not play an intermediary role in the system of stroke classification and treatment.Increasing the closeness of the referral network and forming closer and faster cooperation between medical institutions is beneficial to lower medical costs and length of stay.

Objective Explore the relationship between hospital characteristics and medical costs and length of stay,and thus provide policy recommendations for promoting the system of stroke classification and treatment.Methods Social Network Analysis methods were employed to explore the characteristics of medical institutions in stroke referral network,with multiple linear regression analysis used to explore the impact of network structure metrics on patients'length of stay,total hospitalization costs,and out-of-pocket expenses.Results A total of 11 918 stroke inpatients and 158 hospitals were included in the initial network.As the network threshold increases,the average length of stay per admission decreased from 15.76 days to 15.60 days,the average total hospitalization cost per admission decreased from 12 570.57 yuan to 1 1 897.40 yuan;and the average out-of-pocket cost per admission decreased from 1 745.66 yuan to 1 558.91 yuan.In the network with a threshold of 16,patients were referred a total of 89 740 times,with tertiary hospitals having the highest number of referrals(23 485 times for referral out and 21 371 times for referral in).Tertiary hospitals had the highest proportion of hospitals and centrality metrics in the referral network,except for degree centrality in the densest network.Higher centrality was associated with lower total hospitalization costs and out-of-pocket expenses,while higher closeness centrality was associated with shorter length of stay.Conclusion Tertiary hospitals occupied a dominant position in the stroke referral network.Secondary hospitals did not play an intermediary role in the system of stroke classification and treatment.Increasing the closeness of the referral network and forming closer and faster cooperation between medical institutions is beneficial to lower medical costs and length of stay.