Objective To evaluate the outcomes of the payment reform at public hospitals in Sanming city.Methods Interrupted time series analysis was used to compare changes of the average days of stay,per capita hospitalization expense,outpatient expense per visit,proportion of medical expense and that of drugs during hospitalization at 21 public hospitals at or above county level before and after the DRGs reform.Results Comparisons before and after the reform found the average days of stay at the original momentum,poor control in curbing the proportion of medical expense and that of drugs during hospitalization,adropping followed by rising trend in the outpatient expense per visit,and minimal drop of the abovementioned proportions.Conclusions The rapid growth of outpatient and hospitalization costs at tertiary hospitals may be incurred by unreasonable cost transfer,structural trend of hospitalization expense makeup,and rationality pending scrutiny.

Tripartite-sector reform (a synergistic reform in public health services,medical insurance and medicine production-circulation) in Sanming city was described in the paper which centers on medical insurance.Tapping full potentials of the medical insurance,the city achieved efficient synergy among healthcare,medical insurance and medication systems.This reform has trimmed out inflated drug pricing to some extent for rooms of maneuver of medical service pricing changes,thus curbing excessive growth of medical costs successfully.The authors proposed areas of further improvements including the relationship between achieving such objective as curbing medical expenditure,and advancement of technical/medical service capacity;that between integrative control of medical insurance expenditure and protection of people's health;the equilibrium of interests between medical insurance,healthcare and medication.All these will contribute to the goal of healthy patients flow and a hierarchical medical system.

Objective To investigated to implement condition of preventive measure and control effect for endemic fluorosis in Fengshun County from 2005 to 2006.Methods It was investigated according to the National Surveillance Program of Endemic Fluorosis.Hupo,Daizai and Anquan Villages of Tangxi Town in Fengshun County were selected as monitoring spots.The usage of reforming water facilities,fluoride content in drinking water and urine of children aged 8-12 years and the prevalence rate of dental fluorosis of children were investigated.Resul tsin 2005 and 2006.a total of 18 reforming water facilities were surveyed and six of which were damaged or out of service.In 2005,the fluoride content in drinking water in the 3 villages was 2.10,1.22 and 0.15 mg/L The prevalence rate of dental fluorosis of children aged 8-12 years was 54.23%(64/118),38.91%(79/203) and 9.10%(6/66).The urine fluoride content of children was 0.95,0.90 and 1.05 mg/L,respectively.In 2006,the fluoride content in drinking water in Hupo,Daizai and Anquan Village was 2.01,1.57 and 0.21 mg/L.The prevalence rate of dental fluorosis of children aged 8-12 years was 26.47%(27/102),12.50%(23/184)and 6.15%(4/65),respectively.The urine fluoride content of children was 0.97,0.61 and 0.59 mg/L.Conclusions The outcome of surveillance data in Fengshun County has reached the sanle level as that of non-disease area.However,the management of reforming water facilities should be improved.

Objective To investigate the clinical efficacy of Qishen Xiaodian Decoction combined with laser acupoint irradiation for treatment of recurrent Hen?ch-Sch?nlein purpura (HSP) in children. Methods Totally 120 cases of children with recurrent HSP were divided into treatment group and control group according to the digital random table method, with 60 cases in each group. The control group was given anti-allergy, hormones, immunosuppressive agents and other conventional treatment for 4 weeks, while the treatment group was treated with Qishen Xiaodian Decoction based on conventional treatment, 1 dose each day, morning and night (age 4–5 take 1/3 dose, age >5–10 take the half dose, and age >10–14 take the whole dose), for 4 weeks. Zusanli, Xuehai, and Sanyinjiao acupoints were under laser vertical irradiation, 12 min for each time, once a day for 2 weeks. The disappearing time of the main symptoms and the total effective rate of the two groups were compared. Peripheral blood contents of Th17 and Treg cells and serum interleukin-17 (IL-17), and transforming growth factor β1 (TGF-β1) level before and after the treatment were observed. The recurrence rate in 6 months and in 12 months of the two groups were compared. Results The disappearing time of rash, abdominal pain and joint swelling pain and kidney damage of the treatment group were less than those of the control group (P<0.01). The total effective rate was 95％(57/60) in treatment group, significantly higher than control group 80％ (48/60), with statistical significance (P<0.05). Compared with before treatment, Th17 cell content, serum IL-17 and TGF-β1 decreased, and Treg cell content increased after treatment of the two groups (P<0.01). Compared with the control group, contents of Th17 cell and serum IL-17 of the treatment group decreased (P<0.01). The recurrence rate was lower than that of the control group in 6 and 12 months after treatment, with statistical significance (P<0.05). Conclusion Based on the conventional western medicine treatment, Qishen Xiaodian Decoction combined with laser acupoint irradiation on recurrent HSP in children can quickly relieve symptoms and reduce the recurrence rate.

OBJECTIVETo explore the incidence and risk factors of campus violence in Guangzhou.

METHODS2200 college students in three universities in Guangzhou were selected by cluster sampling method and were interviewed with self-designed questionnaire about the incidence and risk factors of campus violence in 2010. The final analysis sample was 2103. Chi-square test was used to analyze the gender, grade and major distribution of campus violence. Logistic regression method was used to analyze the influencing factors of campus violence in bully and victim.

RESULTSThe incidence of campus violence in Guangzhou was 69.9% (1471/2103). In boys and girls the incidence of campus violence was 75.6% (830/1098) and 63.8% (641/1005) (χ(2) = 34.82, P < 0.05). The incidence of bully and victim of campus violence was 63.6%(1338/2103) and 55.3% (1163/2103). The incidence of bully and victim in boys was 70.9%(778/1098) and 60.0%(659/1098), and in girls was 55.7% (560/1005) and 50.1% (504/1005) (χ(2)(bully) = 51.93, χ(2)(victim) = 20.68, P < 0.01). The incidence of psychological violence was the highest (68.0%, 1430/2103), followed by sexual violence (34.2%, 719/2103), the incidence of physical violence was the lowest (16.5%, 348/2103). Results of logistic regression showed that boys (OR = 1.60), arts (OR = 1.82), with siblings (OR = 1.31), the living expenses was not enough (basic enough OR = 1.35, not enough OR = 1.54), playing the computer games (OR = 1.70), playing tricks such as sliding plate (OR = 2.03), loving violence program (general OR = 1.30, very like OR = 1.44), mother with gamble behavior (OR = 4.29), father's indulgent education style (OR = 1.60), been bullied by others before high school (OR = 1.61), dissatisfaction to the environment and rules of campus (nothing special feeling OR = 1.67, some dissatisfaction OR = 1.89), been treated badly by primary school teacher (one kind OR = 1.35, two kinds and above OR = 1.90)were the risk factors of bully. Boys (OR = 1.23), minority (OR = 1.71), with siblings (OR = 1.39), bad behavior and habit (OR = 1.32), the bad family economic conditions (general OR = 1.51, difficult OR = 1.88), mother with gamble behavior (OR = 2.33), father's indulgent education style (OR = 1.37), occasional physical punishment by mother (OR = 1.35), been bullied by others before high school (sometimes OR = 1.61, often OR = 1.85), high pressure during the study (a little high OR = 1.37, very high OR = 1.40), dissatisfaction to the environment and rules of campus (some dissatisfaction OR = 1.56, completely dissatisfaction OR = 2.04), been treated badly by primary school teacher (one kind OR = 1.70, two kinds and above OR = 2.04)were the risk factors of being victim.

CONCLUSIONThe campus violence in Guangzhou is serious, especially the psychological violence and sexual violence. And the risk factors of campus violence in bully and victim are multifold.

Adolescent ; Adult ; China ; Female ; Humans ; Incidence ; Logistic Models ; Male ; Risk Factors ; Students ; psychology ; Surveys and Questionnaires ; Universities ; Violence ; statistics & numerical data ; Young Adult

OBJECTIVETo analyze the epidemiology status and risk factors of disabilities caused by injury in Guangdong province.

METHODSStratified multi-stage cluster sampling was used to identify 1530 subjects with disabilities (among them, 415 disabilities caused by injury), in the villages or districts in the four regions of Guangzhou, Qingyuan, Zhaoqing and Huizhou in 2010. Subjects were interviewed by trained staff with self-made questionnaires about the status of the disabled, then 415 disabled caused by injury were interviewed about the process of the injury causing disability. The variables in this survey included gender, regions, rural (urban) residences, occupation, age and injury style. The difference of injury were analyzed through χ(2) test, and the influencing factors were explored through classification tree model.

RESULTSThe top five causes of disability were road traffic injury, fall, work-related injury, medical accident, scald or burn, accounting for 32.53% (135/415), 21.45% (89/415), 12.77% (53/415), 8.43% (35/415) and 5.06% (21/415), respectively. The proportion of male was higher than female in all disabilities caused by injury (295 male, 117 female, 3 unknown). Female had higher proportion 8.55% (10/117) than male 3.05% (9/295) with the cause of scald or burn (χ(2) = 6.302, P = 0.012), the proportion of rural residents 38.89%(84/216)was also higher than urban residents 25.63% (51/199) in disabilities caused by traffic accident (χ(2) = 43.850, P < 0.001); and the proportion of rural residents 25.46%(55/216)was also higher than urban residents 8.55% (34/199) in disabilities caused by the fall (χ(2) = 8.257, P = 0.004). Different age groups and regions had different types of injury causing disability, 53.08% (69/130) traffic accident and 51.92% (27/52) work-injury mainly caused disability in 25 - 44 age group, 85.71% (30/35) medical accident and 76.20% (16/21) scald or burn mainly caused disability in 0 - 14 age group, the injury caused by the fall was 62.50% (5/8) in 65- age group. The proportions of fall in Qingyuan 29.09% (16/55) and Huizhou 28.23% (37/131) were significantly higher than that in Guangzhou 13.38% (21/157) and Zhaoqing 21.13% (15/71) (χ(2) = 11.904, P = 0.008). The proportions of work-injury in Guangzhou 19.11% (30/157) and Zhaoqing 19.72% (14/71) were significantly higher than that in Qingyuan 0.00% (0/55) and Huizhou 6.09% (8/131) (χ(2) = 22.309, P < 0.001). The proportions of disabled by scald or burn in Guangzhou 10.83% (17/157) and Qingyuan 0.00% (0/55) were significantly higher than that in Zhaoqing 1.41% (1/71) and Huizhou 2.27% (3/131) (χ(2) = 17.826, P < 0.001). Classification tree model revealed that the age group, occupation and urban-rural were major factors influencing intended harm, the highest proportion of the intended harm was in 25 - 44 age group (59.21%, 151/255).

CONCLUSIONThe road traffic injury, fall, work-related injury, medical accident and scald or burn were main causes of disability in Guangdong province. Gender, age, and urban-rural factors were associated with disabilities caused by injury.

Accidents ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Disabled Persons ; Factor Analysis, Statistical ; Female ; Humans ; Infant ; Male ; Middle Aged ; Risk Factors ; Surveys and Questionnaires ; Wounds and Injuries ; epidemiology ; Young Adult

Objective To describe and analyze the prevalence and epidemiological features of people with disability caused by injury in the Chinese population, and to provide scientific basis for developing the prevention and control programs on injuries. Methods Statistics and infervention measures were used to analyze the data from the Second China National Sample Survey on injury-caused Disability. Cluster analysis was used to analyze the differences in regions. Results The overall prevalence of disability caused by injury was 99.68/10 000 which occupied 15.59% of all the disability, with multiple disability excluded. Physical disability and hearing disability accounted for 65.59% and 23.35% of all the injury-caused disability respectively, while those ranked Grade Ⅳ and Ⅲ making up the majority(55.14% and 25.83%)of the disability, respectively. There were significant differences in the distribution of injury-caused disability among different age groups(x2= 23 106.14,P＜0.001)and gender(x2=2161.74, P＜0.001). Ageing and being males having a higher risk on injury- caused disability. Five clusters were identified by cluster analysis, in which injury-caused disability were severe in the fifth(Sichuan province)and the fourth clusters(Hunan, Chongqing,Guizhou, Ningxia province). Conclusion Problems discovered by injury-caused disability in the Chinese population should not be ignored. Both physical and hearing disabilities appeared to be the two main types of disability while age, gender and region were related to injury-caused disability.Targeted strategies should be developed to decrease the injury-caused disability in China.

OBJECTIVESTo analyze the epidemiology information of prostate cancer from three centers of Beijing, Shanghai, Guangzhou, and to reflect the current situation of prostate cancer in China, and to analyze the information of 272 patients with advanced prostate cancer who received hormonal therapy to find the prognostic factors of hormone therapy.

METHODSCollect the information of 525 patients with prostate cancer from three centers. Two hundred and seventy-two cases of advanced prostate cancer with full information were selected from the 525 cases to analyze the prognostic factors of hormone therapy.

RESULTSThree hundred and fifty-seven cases (68.0%) had advanced disease at diagnosis and 80.2% patients received hormone therapy as the main therapy. Prognostic analysis indicated that Gleason score, bone metastasis and prostate specific antigen nadir were independent prognostic factors of progression-free survival time.

CONCLUSIONSIn this report, most patients are advanced prostate cancer at diagnose, and hormonal therapy is the main therapy. Gleason score, bone metastasis, prostate specific antigen nadir are independent prognostic factors of advanced prostate cancer after hormone therapy.

Adult ; Aged ; Aged, 80 and over ; Androgen Antagonists ; therapeutic use ; Antineoplastic Agents, Hormonal ; therapeutic use ; China ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prostatectomy ; Prostatic Neoplasms ; epidemiology ; pathology ; therapy ; Survival Analysis

OBJECTIVEDespite the causes for melanin increase, the increased gene expression of TYR is a common pathological process. Based on this viewpoint, antisense-S-Oligo of TYR was designed and synthesized to regulate synthesis of melanin in order to explore the treatment for skin pigmentation.

METHODSThe cultured melanocytes were divided into 3 groups. The group 1 was treated with endothelin, group 2 treated with ultraviolet ray and group 3 was used as the control. In each group, the 5' antisense-S-Oligo, the 3' antisense-S-Oligo, the mixed antisense-S-Oligo of TYR or Dotap only was added. The melanin content and TYR gene expressions were examined.

RESULTSThe 5' antisense-S-Oligo, the 3' antisense-S-Oligo and the mixed antisense-S-Oligo significantly inhibited the increase of melanin content and TYR gene expression, which were caused by endothelin or ultraviolet ray treatment. Of the three treatments, the 3' antisense-S-Oligo showed the strongest effect.

CONCLUSIONAntisense-S-Oligo has significant regulating effects on TYR gene expression and melanin content. The 3' antisense-S-Oligo is more effective than the 5' antisense-S-Oligo.

3' Flanking Region ; genetics ; 5' Flanking Region ; genetics ; Endothelins ; pharmacology ; Gene Expression ; Melanins ; biosynthesis ; Melanocytes ; drug effects ; metabolism ; radiation effects ; Oligodeoxyribonucleotides, Antisense ; genetics ; pharmacology ; Tyrosine ; genetics ; metabolism ; Ultraviolet Rays

BACKGROUNDThe temporal bone has the most complicated anatomic feature among the whole human body, which always challenges otolaryngologists. This study was to study three-dimensional (3D) morphology of the temporal bone and the ear by means of a computer image processing technique, for the purpose of providing a 3D image to help in pathological, diagnostic and surgical procedures.

METHODSForty sets of temporal bone celloidin serial sections with reference points were prepared and the contours of selected structures and reference points were entered into a graphics programme. The technique of computer-aided 3D reconstruction was applied to obtain 3D images and parameters of the temporal bones and the ears. Stereo views of the ossicles (n = 5), the facial nerves (n = 11), the posterior tympanic sinuses (n = 11), the posterior ampullary nerves (n = 4), the endolymphatic ducts and sacs (n = 5), and the bony and membranous labyrinth (n = 1) were reconstructed.

RESULTSThree-dimensional images, including the cochlea, the ossicles, the nerves, the tendons and the endolymphatic fluid system in the temporal bone, were obtained. Stereo picture pairs and 3D parameters of spatial dimensions, angle and volume for these reconstructed structures were calculated. The arrangement of the ossicles, spatial relationship of the bony and membranous labyrinth, the whole course of the facial nerves, the endolymphatic sac and posterior tympanic cavity were clearly observable. Stereo picture pairs made the spatial relationships among the above-mentioned structures much clearer. The operation of the posterior ampullary nerve transection was designed and simulated on the graphic computer based on 3D anatomic investigations.

CONCLUSIONThe technique of computer-aided 3D reconstruction provides a new tool to observe the morphology of the temporal bone and thus may allow design and study of new surgical approaches.

Ear ; anatomy & histology ; Facial Nerve ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Temporal Bone ; anatomy & histology