Objective To verify that traditional Chinese medicines have certain price advantages compared with western medicines,and to estimate the rational increase in the compensation proportion of traditional Chinese medicine in the new rural cooperative medical system.Methods Using stratified sampling survey and literature review,the average outpatient and hospitalization expenses in the treatment of common diseases in rural areas were calculated and compared among traditional Chinese medicine,western medicine,and integrated traditional and western medicine.Results For average outpatient and hospitalization expenses,traditional Chinese medicine was lower than western medicine,integrated traditional and western medicine was lower than western medicine.and traditional Chinese medicine was lower than integrated traditional and western medicine.For hospitalization expense,traditional Chinese medicine had a 25.2%lower expense compared with western medicine.The ratios of expenses were statistically calculated,and the mathematical model for the compensation proportions of traditional Chinese medicine and western medicine in the new rural cooperative medical system was put forward.Conclusions In the implementation scheme of new rural cooperative medical system,the compensation proportion of traditional Chinese medicine in outpatient and hospitalization expenses should be increased by 25%and 33%respectively compared with western medicine.

[Summary] To investigate the difference in serum pigment epithelium-derived factor ( PEDF) among type 2 diabetic patients before and after use of dipeptidyl peptidase-4 inhibitors linagliptin for treatment, and to explore the correlation of serum PEDF with lipids, body mass index, and HbA1C . 39 patients with recently diagnosed type 2 diabetes and 30 healthy individuals were enrolled. Baseline weight, waist circumference, body mass index, fasting plasma glucose, HbA1C , serum glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase, total cholesterol, triglyceride, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol ( LDL-C) , and PEDF measured by enzyme linked immunosorbant assay were determined both in the diabetic and control subject. The treatment group was treated with oral linagliptin 5 mg/d for six month, serum PEDF and clinical parameters were determined in the diabetic group during 6 months of treatment. ( 1 ) PEDF levels were found to be comparable with the controls ( P=0. 584);LDL-C and waist circumference showed positive correlation with PEDF(P<0. 05 or P<0. 01). (2) PEDF level was significantly increased in patients with type 2 diabetes after linagliptin treatment [(3. 21 ± 1. 91 vs 2. 45 ± 1.53)μg/ml,P<0.01]. SerumPEDFlevelinpatientswithtype2diabeteswassimilartothatofhealthycontrolswith associated LDL-C and waist circumference. After linagliptin treatment, serum PEDF level was raised, suggesting that it may have certain protective effect for diabetic vascular complications.

Ojective To investigate the relationship between the serum adiponectin concentration and insulin resistance in patients with obesity and diabetic patients. Methods Fasting serum adiponectin concentration was measured by RIA in 19 normal subjects, 23 obese subjects, 31 diabetic patients without obesity and 26 diabetic patients with obesity. Results There was no significant difference in serum adiponectin concentration between nomal and obese subjects, and between type 2 diabetics without obesity and type 2 diabetics with obesity . The serum adiponectin concentrations was significantly higher in type 2 diabetics without or with obesity than that in nomal and obese subjects. There was significant difference in serum adiponectin concentration between female and male subjects. Body mass index (BMI), waist circumference(WC), waist-hip ratio (WHR), body fat percentage (BF%), fasting plasma glucose (FPG), insulin sensitivity index (ISI), triglyceride (TG) and high density lipoprotein-C (HDL-C) were significantly correlated with serum adiponectin concentration. A stepwise mulitiple linear regression analysis showed that HDL-C, FPG, WC, BF% entered the regression equation. Conclusion Serum adiponection level was associated with sex, obesity, type 2 diabetes mellitus and insulin resistance.

Objective To investigate the plastic surgery of facial soft tissue for improvement of facial contour. Methods Botulinum toxin type A was injected into hypertrophied masseter to make it atrophy and attenuation; meanwhile, buccal fat lining was partly resected by intra-oral approach. Buc-cal liposuction was performed if necessary. Results 36 cases got satisfactory face thinning results af-ter treatment. The facial contour of all patients was markedly improved. Following up for 6 - 12 months showed that the effect was stable. Conclusion Plastic repair of facial soft tissue for improve-ment of facial contour is a simple approach, with mild injury, quick recovery, safe and effective.

Objective To explore the effect of antimicrobial use density (AUD) on the detection rate of methicillin-resistant Staphylococcus aureus (MRSA) and antimicrobial resistance rate of healthcare-associated Staphylococcus aureus (HA-SA) half a year later.Methods From 2012 to 2015,all types of AUD,detection rate of MRSA,and antimicrobial resistance rate of HA-SA were calculated semiannually,correlation between antimicrohial resistance rate of HA-SA and all types of AUD in the same first half of year were analyzed with correlation analysis and multiple linear regression.Results From the first half of 2012 to the latter half of 2015,the total AUD declined from 128.2 to 49.0,except the AUD of carbapenems rose,AUD of other antimicrobial agents declined.From the latter half of 2012 to the latter half of 2015,104 249 patients were admitted to the hospital,and 1 008 strains of SA were isolated from 40 884 specimens,857 (85.02％) of which were community-associated SA(CA SA) and 151 (14.98％) were HA-SA.Isolation rate of HA-MRSA declined from 31.25％ in the latter half of 2012 to 12.50％ in the latter half of 2015;isolation rate of CA-MRSA rose from 7.08％ to 16.08％,resistance rate of HA-SA was generally higher than that of CA-SA.Antimicrobial resistance rate of HA-SA to ciprofloxacin remained the same,to levofloxacin increased,to 8 other antimicrobial agents all declined;resistance rates of CA-SA to oxacillin,ciprofloxacin,clindamycin,gentamicin,and levofloxacin increased,but to other antimicrobial agents declined;no SA strains was found to be resistant to vancomycin and linezolid.The resistance rate of HA-SA to azithromycin and erythrocin was correlated with the AUD of macrolides,resistance rate of HA-SA to clindamycin was correlated wvith the AUD of aminoglycosides,to gentamicin was correlated with the AUD of macrolides and the total AUD.Conclusion The selective pressure of antimicrobial agents is still the important cause of the occurrence of antimicrobial resistance,decreasing the AUD of antimicrobial agents will help for reducing the detection rate of HA-MRSA and drug resistance rate of HA-SA.

Objective To investigate changes in serum sclerostin (SO) in postmenopausal women before and after treatment with recombinant human parathyroid hormone (1-34) [rhPTH (1-34)],and to explore the relationship of serum SO with estradiol (E2),and bone mineral density (BMD).Methods Ninety-five postmenopausal women were divided into normal BMD group (n =41) and osteoporosis group (n =54).Body mass index,alkaline phosphatase (ALP),serum E2,calcium,phosphate,and SO were determined in both groups.The patients in osteoporosis group were treated with rhPTH (1-34) 20 μg/d by subcutaneous injection and oral calcium 500 mg/d for 12 months.Serum calcium,serum phosphate,BMD,serum ALP,serum E2,and sclerostin were determined in osteoporosis group by 6 months and 12 months of treatment.Results (1) Serum level of SO in osteoporosis group was raised significantly as compared with normal BMD group (P ＜ 0.05) ; E2 and BMD were negatively correlated with SO; age and postmenopausal years were positively correlated with SO (P ＜ 0.05).(2) Serum SO was reduced gradually with treatment of rhPTH (1-34) by 6 months and 12 months (P ＜ 0.05).Conclusions Serum SO was increased in postmenopausal women,which was related to E2 and BMD,and was reduced gradually with treatment of rhPTH (1-34).SO may participate in the development of postmenopausal osteoporosis.

AIM: To investigate the effects of metallothionein (MT) induced by zinc on doxorubicin (DOX)-treated mice and to explore the potential mechanisms. METHODS: Male C57BL/6J mice were divided randomly into 4 groups (n = 6) following control, DOX, Zn and Zn plus DOX. Mice were pretreated with eikg-1, ip) or equal volume of saline, and were killed on d 4 after the last injection. Serum and hearts were collected for examination. RESULTS: Zinc pretreatment elevated cardiac MT levels significantly while other antioxidants in heart including glutathione (GSH), glutathione peroxidase (GSHpx) , superoxide dismutase (SOD), and catalase (CAT) were not altered. Severe oxidative injury occurred in the mice treated with DOX as myocardial lipid peroxidation and morphological changes manifested by myocardial fibers swelling and vacuolization and nuclear condensation or dissolution, with increased activities of serum creatine kinase and lactate dehydrogenase and depletion of GSH, GSHpx, and SOD while CAT activity was increased in compensation. However, pre-induction of MT with zinc attenuated all of these toxic changes significantly. Furthermore, DOX induced elevation of hydrogen peroxide in heart tissues was greatly inhibited by zinc pretreatment. CONCLUSION: Preinduction of MT by zinc protects the heart from DOX-induced cardiotoxicity, and this effect is possibly correlated with the property of MT on scavenging free radicals in vivo.

ObjectiveTo investigate the effect of rhPTH (1-34) and elcatonin on bone metabolism and serum secreted protein acidic and rich in cysteine ( SPARC ) in postmenopausal women with osteoporosis.Methods One hundred and twenty-four postmenopausal women with osteoporosis were randomly divided into 2 groups:One group was treated with recombinant human parathyroid hormone ( 1-34 ) [ rhPTH ( 1-34 ) ] 200 U/d by subcutaneous injection (PTH group,n =89 )and another group was treated with elcatonin 20 U/week by intramuscular injection (CT group,n =35 ) for 12 months.All patients received a basic therapy with oral calcium ( Ca 600 mg+ Vit D3125 U,q..d.).The bone mineral density ( BMD ) of lumbar spine( L2-4 ),the left femoral neck,greater trochanter,and Ward's triangle,serum calcium and phosphate were measured by baseline,6 months' and 12 months.Levels of serum bone-specific alkaline phosphatase( BSAP),serum secreted protein acidic and rich in cysteine (SPARC)were determined by an ELISA assay.ResultsBy 12 months,rhPTH ( 1-34 ) treatment significantly increased the lumbar spine L2-4 BMD 7.9％ (P＜0.05),serum calcium 8.3 ％ ( P＜ 0.05 ),serum BSAP 93.4％ ( P＜ 0.05 ),serum SPARC by 12.6％[ ( 195.68±59.57 vs 173.81 ±81.33 ) pμg/L,P＜0.05 ].Elcatonin therapy increased the lumbar spine L2-4 BMD by 3.2％ (P＜0.05) at the end of 12 months,but elcatonin did not influence serum calcium,BSAP and SPARC.The rhPTH( 1-34 ) increased lumbar spine L2-4 BMD more than elcatonin did at 12 months( P＜0.05 ).ConclusionrhPTH (1-34) could promote the bone anabolism more effectively than elcatonin did.Serum SPARC may play an important role in promoting osteogenesis by rhPTH.

Objective:To compare the survival outcomes in patients of small cell lung cancer (SCLC) with brain-single metastasis and brain with organs-multiple metastasis.Methods:Using the US surveillance, epidemiology and final results database, 5 520 SCLC patients with complete clinical information from 2004 to 2015 were selected. SCLC patients were adjusted, stratified or matched according to the metastasis site after the stratification or matching of the propensity scores, and the lung cancer-specific survival (CSS) rate and overall survival (OS) rate were compared between brain-single metastasis group and brain with organs-multiple metastasis group. In addition, the effects of chemotherapy and radiotherapy in CSS between brain-single metastasis group and brain with organs-multiple metastasis group were compared.Results:Of the 5 520 SCLC patients, 2 658 cases was in the brain-single metastasis group, and 2 862 cases was in brain with organs-multiple metastasis group. After the stratification or matching of the propensity scores, the median survival time in brain-single metastasis group was significantly longer than that in brain with organs-multiple metastasis group (6 months vs. 4 months), and there was statistical difference ( P<0.05). The fatality rate in brain-single metastasis group was significantly lower than that in brain with organs-multiple metastasis group (80.66% vs. 85.96%), and there was statistical difference ( P<0.01). Kaplan-Meier survival curve analysis result showed that the OS rate and CSS rate in brain-single metastasis group were significantly higher than those in brain with organs-multiple metastasis group (14.72% vs. 9.50% and 19.34% vs. 14.04%), and there were statistical differences ( P<0.05). Cox analysis result showed that age, race, T stage, gender, N stage, radiotherapy, chemotherapy, tumor diameter, marriage and metastasis were the influencing factors of CSS rate in SCLC patients with brain metastasis ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that radiotherapy and chemotherapy can significantly improve the CSS rate ( HR = 0.668 and 0.671, 95% CI 0.570 to 0.783 and 0.573 to 0.786, P < 0.01). Conclusions:The survival rate in SCLC patients with brain-single metastasis is higher than that of SCLC patients with brain with organs-multiple metastasis; chemotherapy and radiotherapy can improve the survival rate in SCLC patients with brain metastasis.

Objective To investigate the potential of polylactic acid glycolic acid copolymer (PLGA) composite ordered multi tunnel collagen scaffold in fabricating a biomimetic artificial nerve graft to repair the sciatic nerve defects in rats.Methods The ordered multi tunnel collagen scaffold was prepared by vacuum freeze-drying and directional drawing method to simulate the epineurium;the outer conduit was prepared by PLGA to simulate the epineurium;and then,the ordered multi tunnel collagen scaffolds were loaded in the PLGA conduit (5∶1) under a stereomicroscope to develop a novel biomimetic artificial nerve.Sixty-four rats were randomly divided into four groups:artificial nerve group,PLGA group,peripheral nerve group,and non-graft control group (n=16);rats in the artificial nerve group,PLGA group,and peripheral nerve group were repaired with artificial nerve graft,hollow PLGA conduit and allogeneic sciatic nerve to bridge the sciatic nerve defect,while the sciatic nerve with the gap in rats of the control group was without any grafting.After 11 weeks of operation,the hind limbs of rats in each group were detected by behavioral test,electrophysiological examination and Fluoro-Gold retrograde tracing method.The changes of muscle tissues (gastrocnemius) were observed by hematoxylin staining and TMR-α-BTX staining,and the regenerated axons were observed by immunohistochemical staining with NF200 and the regenerative spinal anterior horn motor neurons were observed by Nissl fluorescence staining 12 weeks after operation.Results After 11 weeks of operation,the recoveries of the motor functions (the distance between the injured hindlimb and forelimb,the rotation angle of the injured foot) in the peripheral nerve group,artificial nerve group,PLGA group and control group were significantly deteriorated in turn,and the differences were statistically significant (P＜0.05).Electrophysiological examination showed that the recovery effect of peripheral nerve group was the best in both latency and amplitude of the compound muscle action potential,followed by artificial nerve group.The latency of PLGA group was the longest and the amplitude of compound action potential was the smallest;significant differences were noted between each two groups (P2＜0.05).At 12 weeks after operation,the wet weight ratio of muscle fibers,area of muscle fibers and neuromuscular junction area were significantly different between each two groups (P＜0.05);the degree of gastrocnemius atrophy in the artificial nerve group was significantly improved than that in the PLGA group,but not yet reached the level of peripheral nerve group.NF200 immunohistochemical staining showed that a large number of NF200-positive axons were seen in the grafts of the artificial nerve group,but the number was slightly smaller than that of the peripheral nerve group;the number of regenerated axons in the PLGA group was the smaller and mainly distributed near the proximal side.In the PLGA group,only (19.33 ±6.73)％ regenerated spinal anterior horn motor neurons were labeled with Fluoro-Gold,while the positive rates of Fluoro-Gold in the artificial nerve group and peripheral nerve group were (42.67±7.45)％ and (50.13±4.33)％;the differences between each two groups were statistically significant (P＜0.05).Conclusion The biomimetic artificial nerve made of PLGA conduit and ordered multi tunnel collagen scaffold can efficiently reconstruct the defected peripheral nerve with guiding axonal regeneration and promoting functional restoration in rats;however,its effect is poor than peripheral nerve grafting.