Discussed in the paper are case-based payment practice in China,and outcomes of this practice for the past ten years.The authors pointed out that compared with DRGs,such a practice is exposed to such risks as low coverage of diseases,incompatible policies,defective pricing method,and lack of comprehensive evaluation.It indicates that China is on the initial stage of case-based payment reform which should be promoted with reference to international experiences.

The changes in shape, structure and function of red blood cells (RBC) after cold storage were observed by using slow cold storage technique. Before and after cold storage, RBC mean corpuscular volume (MCV), RBC fragility (RF), whole blood viscosity (WBV), RBC deformity (RBCD), LFU, SatO2, hematocrit (HCT), RBC recovery rate (RBCRR) and RBC immune function were measured. The result showed that after resuscitation, RBC had vital resistance to hypotonic solution. There was no significant difference in MCV, RBCD and LFU (P>0.05). HCT and WBV were decreased and RBCRR reached 84.1 %(all P<0.01). SatO2 was increased from 30.5 % to 98.2 %. RBC immune function showed no significant difference (P>0.05). It was suggested that quality of RBC didn't change after cold storage and RBC could be cryopreserved for a long time.

There are 13 members of the Let -7 miRNAs family which is regarded as tumor suppressor gene, locating in nine different chromosome loci. Lin28 acts as negative regulatory factor of miRNA biological recurrence. By selectively blocking the processing synthesis of the Let-7 miRNAs family, Lin28 block the inhibition effect of miRNA of proto-oncogenes and interact with RNA helicase to enhance gene translation at the same time. By not quite clear mechanism, an up-regulation of Let-7 inhibits the expression and function of Lin28. In more and more studies of human tumor, Lin28/Let-7 axsis was proved to be important significance of the tumor's occurrence and development. In this paper, we research briefly the recent progress of the molecular mechanism and related influence factors of ILin28/Let-7 axsis.
Animals ; Humans ; MicroRNAs ; RNA-Binding Proteins

The efficiency of cold storage red blood cells (CSRBC) or whole blood at -80 degrees C used in 27 Rh (D) negative patients during surgical operation was reported. The Rh (D) negative patients received the transfusion of CSRBC or whole blood stored at -80 degrees C for 180 to 360 days. The changes in the indexes, such as blood TB, DB, K+, Na+, BUN, Cr, urine protein (URPO), UOB, Hb, HCT, serum total protein, relative to hemolytic reaction and blood volume before and after transfusion were observed. The results showed that after transfusion of CSRBC or whole blood 27 cases were negative for urine protein and UOB, and the levels of BUN and Cr were normal (P > 0.05). Blood TB, DB, Hb, and HCT were increased, while pH, blood K+ and blood Na+ was normal with the difference being not significant before and after operation (P > 0.05). Plasma protein was decreased, but there was no significant difference before and after operation (P > 0.05). It was suggested that CSRBC or whole blood at -80 degrees C could be safely infused to the Rh(D) negative patients without side effects during the surgical operation.
Blood Preservation/*methods ; Blood Transfusion/*methods ; *Cryopreservation ; Erythrocytes ; Intraoperative Care ; *Rh-Hr Blood-Group System

Objective To explore the application of PBL (Problem - Based learning) mode in fami-ly peritoneal dialysis training to improve the teaching effects of peritoneal dialysis training. Methods The PBL mode was applied in every peritoneal dialysis training lesson, the teaching effects were evalued af-ter a lesson immediately. Results The PBL mode would be helpful to inspire patients' and their family members' interest to learn the knowledge of peritoneal dialysis training.It was also helpful in knowledge un-derstanding, knowledge mastering and establishment of treatment confidence. Conclusions The PBL mode was an important way to improve the teaching effects of peritoneal dialysis training and realize the teaching objective. It is worth applying in practice of peritoneal dialysis training.

Objective To investigate the change of serum pentraxin3 level in different body mass indices groups among the patients with type 2 diabetes mellitus(T2DM) and to analyze its correlation with metabolic indices.Methods A total of 164 T2DM patients were divided into the normal body mass group (A,n=53),over-weight group (B,n=56) and obese group(C,n=55) according to BMI.Serum pentraxin3 level was assayed by ELISA.Then the relationship between serum pentraxin3 levels with BMI.blood glucose,blood lipid andHOMA-IR was analyzed.Results The pentraxin3 levels in the group A,B and C were (3.46±0.19),(2.47 ± 0.21),(1.44 ± 0.18) ng/mL respectively,the pairwise comparison among three groups showed the statistical difference (P＜0.05).The pentraxin3 level was negatively correlated with BMI,TG,LDL-C,FINS and HOMA-IR (r=-0.897,0.621,-0.232,-0.593,-0.487,P＜0.05 or P＜0.01).The multiple stepwise regression analysis showed that BMI and HOMA-IR were independently correlated with serum pentraxin31evel.Conclusion BMI and HOMA-IR are the independent risk factor for af fecting serum pentraxin3 level in T2DM patients.

OBJECTIVE:To systematically review the efficacy and safety of Danshu capsule in the treatment of chronic chole-cystitis,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Li-brary,Web of science,CJFD,CBM,VIP Database and Wanfang Database,randomized controlled trials(RCT)about Danshu capsule versus other medicines in the treatment of chronic cholecystitis were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extracting and quality evaluating by Cochrane 5.1.0. RESULTS:Totally 12 RCTs were enrolled,involving 1140 patients. Results of Meta-analysis showed the cure rate of Danshu capsule in the treatment of chronic cholecystitis was higher than control group,there was statistically significant difference between 2 groups [RR=1.62,95%CI(1.33,1.96),P<0.001];total effec-tive rate in Danshu capsule group was higher than Ursodeoxycholic acid tablet group[RR=1.37,95%CI(1.14,1.64),P<0.001], Xiaoyan lidan tablet group [RR=1.40,95%CI(1.24,1.58),P<0.001],Jindan tablet group[RR=1.13,95%CI(1.04,1.23),P=0.005] and Danning tablet group[RR=1.16,95%CI(1.05,1.28),P=0.004],there were statistically significant differences among groups. Incidence of adverse reactions of Danshu capsule was lower than control group,there was statistically significant difference between 2 groups [RR=0.20,95%CI(0.12,0.34),P<0.001]. CONCLUSIONS:Both efficacy and safety of Danshu capsule are good in the treatment of chronic cholecystitis.

OBJECTIVE: To analyze and summarize clinical characteristic, treatment scheme and survival rate of primary melanom in nasal cavity and sinus. METHOD: We retrospectively analyzed the 9 patients with primary melanom in nasal cavity and sinus who in data proceed were treated and reviewed the related literature. RESULT: Among the 9 patients, the clinical main symptoms are rhinostegnosis of lateral nasal and intermittent nasal bleeding. Pathologic examination is mainly characterized by tumor cells abnormity and cytoplasm containing pigment or without pigment, and main diagnosis basis is some or all of the positive for HMB45, S-100, melan-A. The survival rate are 88.9% (8/9) of 1-year, 66.7% (6/9) of 3-year and 33.3% (3/9) of 5-year. CONCLUSION The incidence of primary melanom in nasal cavity and sinusis is not frequent in clinic and confirmed by immunohistochemical. The extensive radical excision of focus and combine adjuvant radiotherapy postoperative may improve the survival rate of patients.
Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Melanoma ; diagnosis ; surgery ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; surgery ; Paranasal Sinus Neoplasms ; diagnosis ; surgery ; Retrospective Studies

Objective:To investigate the clinical characteristics, treatments and prognosis of pulmonary arteriovenous fistula (PAVF) related ischemic stroke, as well as summarize the diagnosis and treatment process to screen and confirm PAVF related ischemic stroke.Methods:The clinical data of six PAVF related ischemic stroke patients in the First Affiliated Hospital of Fujian Medical University from January 2015 to January 2019, including clinical manifestations, brain magnetic resonance imaging, risk of paradoxical embolism (RoPE) score, contrast-enhanced transcranial Doppler (cTCD), contrast transesophageal echocardiography (cTEE), chest CT and pulmonary arteriography, were analyzed. PAVF patients were treated with interventional catheter embolization or conservative medication. All patients were followed up for 1.5 to 5.5 years.Results:All the six PAVF related ischemic stroke patients were young and middle-aged. The ratio of men to women was 1∶2. RoPE scores ranged from 6 to 7 points. Recurrent stroke was seen in five patients, and only one patient had primary stroke. Both anterior and posterior cerebral circulation could be involved. Hereditary hemorrhagic telangiectasia (HHT) was common in PAVF patients. Of the six patients, two had definite HHT with PAVF, two had suspicious HHT with PAVF, and the other two had sporadic PAVF. In all the six cases, a grade Ⅳright-to-left shunt (RLS) was observed on cTCD, and a mass of delayed microbubbles in the left atrium appeared on cTEE. One patient was diagnosed with patent foramen ovale (PFO). Lung enhanced CT was applied in all the patients. In three cases, PAVF was found located in left lower lobe. And in other three cases, lesions were located in left upper lobe, right lower lobe and right middle lung, separately. All cases were confirmed with simple type PAVF. Transcatheter embolization was performed to resolve PAVF in five patients. Of five post-operative patients, four cases showed no sign of RLS on cTCD. One patient combined with PFO still remained a small amount of potential RLS after embolization. One patient chose aspirin for conservative medication. All patients had no recurrence of ischemic stroke during the 1.5 to 5.5-year follow-up.Conclusions:PAVF related ischemic stroke patients have a high recurrence rate of ischemic stroke. PAVF related ischemic stroke has no specific brain imaging characteristics. cTCD is recommended for cryptogenic stroke patients with a high RoPE score (≥ 6 points) to detect RLS. If a patient turns out to be positive for RLS, cTEE could help differentiate intracardiac shunt from extracardiac shunt. For patients with cTEE suggesting extracardiac shunt, lung enhanced CT scan is necessary to confirm PAVF diagnosis. Patients who are diagnosed as PAVF can choose transcatheter embolization or surgical resection. cTCD could be used to evaluate the treatment effect.

Objective To investigate mental health literacy (MHL) of community medical staffs in district and town of Zhongshan city,and to provide data to improve MHL of community medical staffs.Methods Totally 352 medical staffs who were not psychiatric physician and 81 psychiatric physician were selected.The Chinese Mental Health Knowledge Awareness Questionnaire (published by Ministry of Health) was used to investigate the awareness rate of mental health knowledge.Five vignettes of two schizophrenia,one bipolar disorder,one depression and one obsessive compulsive disorder,each with 8 related questions,were used to investigate the recognition and response ability.Results The average awareness rate of the two groups was more than 80.0% (87.6%,91.6%).For the item 2(75.6%,88.6%),6(74.1%,62.6%),19(36.5%,65.6%),and 20(74.1%,86.2%),the awareness rates were lower than 80.0%,and there were significant differences between the two groups (x2=8.45,4.92,27.48,6.99,all P<0.05).In vignettes survey,the correct rate was lower in the staffs who did not engaged in the mental health work than those in the other group,the difference was statistically significant(64.6% vs.75.9%,P<0.001).For both of the two groups the correct rate of depression was the lowest(x2=44.46,P<0.001).There was statistically significant difference between the total (x2=141.17,P<0.001).Conclusion The awareness rate of mental health knowledge has reached the national standards for community medical staffs,but they have to improve for some knowledge point.Their recognition and response ability for mental illness should be improved.