It is always an important academic and policy issue to understand the impact of hospital distance on Chinese inpatient service demand in rural areas. It employs household survey data collected from 97 villages in Shandong in 2006 and 2008, and investigates the influences of hospital distance on the demand of famars in rural areas. The discrete choice model is constructed to estimate the inpatient service demand function for patients in rural areas. The empirical analysis finds that the hospital distance is significantly affecting Chinese inpatient service demand in the rural areas. The longer the distance increases, the lower the visiting rate drops. In addition, the impact changes with the changes of hospital level; the lower the primary hospital is, the higher the impact would be. It paper provides new evidence for the understanding of the geographical characteristics of medical health care.

Objective To investigate whether unfolded protein response (UPR) plays a role in the pathogenesis of spondyloarthritis (SpA),and to assess UPR-related gene expression in SpA and other arthritis patients.Methods Eighteen patients with SpA,12 with rheumatoid arthritis (RA) and 6 with osteoarthritis (OA) were recruited.Macrophages were isolated from synovial fluid samples by immunomagnetic separation.The expression of UPR-regulated genes,including binding immunoglobulin protein (BiP),glucose-regulated protein 94 (GRP94),C/EBP homologous protein (CHOP),growth arrested and DNA damage-inducible 34 (GADD34),X-box binding protein 1 (XBP-1) and endoplasmic reticulum DnaJ homolog 4 (ERdj4),was tested by real time polymerase chain reaction (PCR).Results Compared with macrophages in OA patients,the expression of BiP and GRP94 mRNA [(6.06 ± 2.08) × 10-2 vs (1.11 ±0.72) × 10-2 for BiP mRNA,11.80(7.30-38.40) × 10-3 vs 1.27(1.02-4.18) × 10-3 for GRP94 mRNA,both P values ＜0.01] was significantly increased in macrophages in SpA patients.XBP1 mRNA was up-regulated [(12.70 ± 5.20) × 10-3 vs (4.14 ± 2.56) × 10-3,p ＜ 0.01] in SpA group as well.UPR-regulated gene expression in SpA patients with HLA-B27 positive or HLA-B27 negative was similar.However,none of UPR-regulated genes showed different expression between the SpA group and RA group except for GADD34 mRNA [7.30 (5.56-15.40) × 10-3 vs 21.30 (12.20-27.60) × 10-3,P =0.009].Conclusions Our data suggest that UPR possibly participates in the pathogenesis of SpA,although the relationship between HLA-B27 and UPR still needs further investigation.

Objective To evaluate the performance of an improved skin prick test in the screening for allergens.Methods A total of 475 patients with chronic urticaria who aged from 3 to 81 years were enrolled in this study,and classified into the control group (n =235) and research group (n =240).Traditional and improved skin prick test were conducted in the control and research group respectively.The allergen detection rate was compared between the two test methods.Results The allergen detection rate was 65.4％ and 67.2％ respectively for the improved and traditional skin prick test,respectively (P ＞ 0.05).House dust mites were the most common sensitizing agent.Conclusion The improved skin prick test can offer reliable evidence for chnical diagnosis with a relatively convenient and safe procedure.

Objective: To identify the spatio-temporal clustering analysis of mumps in Wenzhou City, Zhejiang Province from 2010 to 2023, so as to provide the basis for improving mumps prevention and control strategies. Methods: Data of mumps cases in Wenzhou City from 2010 to 2023 were collected from the Monitoring and Reporting Management System of Chinese Disease Prevention and Control Information System. The spatio-temporal clustering characteristics of mumps incidence were identified using spatial autocorrelation analysis and spatio-temporal scan analysis. Results: A total of 20 455 mumps cases were reported in Wenzhou City from 2010 to 2023, with an average annual incidence of 17.54/105. There were 12 919 male and 7 536 female cases, with a male-to-female ratio of 1.71∶1. The children aged 5-<10 years had the highest incidence of mumps at 135.29/105. The incidence of mumps showed a downward trend from 46.82/105 in 2010 to 3.59/105 in 2023 (P<0.05). The incidence of mumps peaked from May to July and from November to January during 2010 and 2012, the winter peak became less evident after 2013, and no seasonal trends were observed after 2020. Spatial autocorrelation analysis showed there was a positive spatial correlation of mumps of other years, with the exception of 2018 (all Moran's I >0, all P<0.05). Lucheng District, Longwan District, Ouhai District, Cangnan County and Rui'an City were high-high clustering sites. Spatio-temporal scan analysis showed that the primary clustering area was centered in Nanbaixiang Street, Ouhai District, covering 50 towns (streets), with the clustering time from April 2010 to August 2013; the secondary clustering area was centered in Zaoxi Town, Cangnan County, covering 24 towns (streets), with the clustering time from January 2010 to June 2013. Conclusions The incidence of mumps in Wenzhou City from 2010 to 2023 showed a downward trend. The urban areas, Cangnan County and Rui'an City were the clustering areas.

ObjectiveTo investigate the effects of infrared radiation and magnetic fields on the synovitis of rabbit with experimental knee osteoarthritis (OA).MethodsTwenty-four New Zealand grown rabbits were duplicated for OA model of the knee by extended fixation technique, and after 6 weeks, all rabbits were unchained from fixation. The rabbits were randomly divided into four groups: control group (no treatment), infrared group (treated with infrared radiation ), magnet-therapy group (treated with magnetic fields ) and the combined therapy group (treated with infrared radiation and magnetic fields). At the ends of the first, second and third week after treatment, 2 rabbits in each group were taken to measure the general change and histopathology of their synovium.ResultsCompared with other groups, the severity of synovitis (include the synovium line cells proliferation, the invading of granulation and blood vessels in the underlayer of synovium, the infiltration of inflammatory cells) declined significantly in combined therapy group. Scores of Ayral's index of combined group were significantly lower than other groups ( P<0.05), and there was no significant difference between infrared group and magnet-therapy group ( P>0.05).ConclusionThe combination of infrared radiation and magnetic fields can efficiently suppress the synovitis of OA and alleviate the tissue's destructions.

ObjectiveTo investigate effects of 8Hz 90dB and 8Hz 130dB infrasound on hippocampi ultrastructure of SD rats.Methods60 male SD rats were randomly divided into the control group and experimental group. Rats of experimental group were exposed to 8Hz 90dB or 8Hz 130dB infrasound 2 hours every day for 1,7,14, 21,28,35 and 42 days. As soon as the exposure finished,the right hippocampus of rat was taken and examined by electron microscopy.ResultsHippocampus ultrastructure of rats was changed after only one day exposure to infrasound and the longer exposure to infrasound, the worse ultrastructure changed. But during the latter period,damages of hippocampus ultrastructure became lighter. Different rules were observed between 90dB and 130dB groups.ConclusionInfrasound of 8Hz 90dB and 8Hz 130dB can make hippocampus ultrastructure of rats damaged mainly as denaturalizations. These changes are nonliner with time, and the hippocampus of rats has adaptability to infrasound.

Abstract: Objective　To investigate the fundus arteriosclerosis and its influencing factors in HIV/AIDS patients after long-term highly active antiretroviral therapy (HAART). Methods　The clinical basic data and fundus examination data of 203 HIV/AIDS patients before and after HAART in the Fourth People 's Hospital of Nanning from January 2020 to June 2022 were collected to evaluate the occurrence of fundus arteriosclerosis and analyze its influencing factors. Results　Of the 203 HIV/AIDS patients, 159 patients developed fundus arteriosclerosis, with an incidence of 78.33%, including 33 patients with grade Ⅰ(20.75%), 87 patients with grade Ⅱ (54.72%), 28 patients with grade Ⅲ(17.61%), and 11 patients (6.92%) with Grade Ⅳ. Before HAART, there was no significant difference in CD4+T lymphocyte count, CD8+T lymphocyte count, viral load, white blood cell count, platelet count, hemoglobin, serum creatinine, blood urea nitrogen, triacylglycerol, total cholesterol, fasting blood glucose, alanine aminotransferase, aspartate aminotransferase and serum total bilirubin between the atherosclerosis group and normal group (P>0.05). After 6 months of HAART, CD8+T lymphocyte count, triacylglycerol and fasting blood glucose in atherosclerosis group were significantly higher than those in normal group (P<0.05). In the stratified comparison of CD4+ and CD8+ lymphocyte counts after 6 months of HAART, the proportion of patients with CD4+ lymphocyte count (CD4+)<200 (cells/μL) in the atherosclerosis group was significantly higher than that in the normal group; the proportion of patients with CD4+ lymphocyte count (CD4+)≥500 (cells/μL) was significantly lower than that in the normal group; the proportion of patients with CD8+ lymphocyte count CD8+≥ 800/μL was significantly higher than that in the normal group (all P<0.05). Binary logistic regression analysis showed that opportunistic infection, HIV course, CD4+T, CD8+T lymphocyte count after HAART and triglyceride were independent risk factors for ocular fundus atherosclerosis in HIV/AIDS patients (all P<0.05). Conclusions　The incidence of ocular fundus arteriosclerosis is high in HIV/AIDS patients. More than 4 years of HIV course, combined opportunistic infection, Low CD4+T lymphocyte count after 6 months of HAART, high CD8+T lymphocyte count and high triglyceride level are independent risk factors for ocular fundus arteriosclerosis in HIV/AIDS patients. Fundus screening should be performed before and after HAART in such population, HAART program should be formulated for the risk of cardiovascular disease, and risk management of cardiovascular disease should be strengthened during treatment to improve patient outcomes.

ObjectiveTo study the effects of early rehabilitation on symptom, range of motion (ROM) and motor function of upper extremity of patients with shoulder-hand syndrome after stroke.Methods47 patients were divided into two groups,early rehabilitation group and non-early rehabilitation group.Two groups were treated with comprehensive rehabilitation. The passive ROM, the pain and motor function of affected limb was assessed by Fugl-Meyer Assessment.The evalution was done in pre-treatment and post-treatment respectively. Results1.The passive ROM decreased and the pain of affected limb of the early rehabilitation group were less than the non-early rehabilitation gronp when the shoulder-hand syndrome occour.2.After comprehensive rehabilitation treatment,their clinical symptom ROM and motor function of upper extremity impoved significantly in patients with shoulder-hand syndrome after stroke( P<0.05).The early rehabilitation treatment has better effects. Conclusions The early rehabilitation treatment could decrease the degree of their passive ROM decrease and the pain of affected limb in patients with shoulder-hand syndrome after stroke,and the patients who accepted earlyrehabilitation seemed easly to improve by comprehensive treatment.

Objective To evaluate the clinical results of a procedure for treatment of avulsion fracture of posterior cruciate ligament (PCL) using arthroscopic reduction and Orthocord suture.Methods The clinical data of 13 patients who underwent arthroscopic reduction and Orthocord suture fixation for PCL avulsion fracture of the tibial eminence from October 2009 to June 2010 was analyzed retrospectively.Follow-up assessment including Lysholm knee score,and radiographic evaluation.Results All 13 patients achieved follow-up with 10-14 ( 12 ± 2) months.No significant complications were noted,such as swelling,pain or disability of knee.Drawing test was negative.The preoperative Lysholm score in the 13 knees was (72.3 ±2.8) scores,the postoperative Lysholm score was (93.2 ± 1.8) scores,difference was statistically significant (t =15.8,P＜ 0.05 ).Conclusions Treating PCL avulsion fracture with arthroscopic fixation by use of Orthocord suture can restore ligament length,stabilize fragments,promote early motion.

Objective: To clone the 5＇-flanking region of the human CD34 gene containing transcriptional regulatory sequence (TRS). Methods: According to the registered 5＇-flanking region of CD34 gene, two pairs of primers were designed and net-PCR was used to amplify 661 bp long TRS of CD34 gene. The CD34 TRS fragment was cloned into reported plasmid pEGFP-1. The role of the regulating the specific expression of recombinant plasmid pCD34 EGFP in hematopoietic and non-hematopoietic cells was observed. Results: Restrictive endonuclease identification and DNA sequencing provedthat the CD34 promoter cloned was consistent with the sequence reported to a large extent. It could induce the EGFP gene to express in hematopoietic cell line K562 specifically, while has no effect on hepatocellular carcinoma cell HepG-2. Conclusion: The cloned CD34 gene TRS has the effect of regulating gene expression specifically. The study established the fundament for the construction of specific gene expression vector used in hematopoietic system cells.