Objective To identify the chief factors influencing health insurance patients' hospitali-zation expenses so as to provide basis for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods All the medical insurance cases involving the three disease entities in two hospitals of a certain city for the past three years, which totaled 647, were collected and a statistical analysis was made of the possible influencing factors using multi-stepwise regression analysis. Results The factors influencing the health insurance patients' hospitalization expenses included choice of hospitals, length of stay, performance of operations, proportion of drug fees, and province- wide readjustment of medical service prices. Reducing length of stay and lowering proportion of drug fees were the key to controlling expenses. Conclusion It is imperative to formulate scientific diagnostic and treatment routines and expense standards for single disease entities, speed up and deepen reform in the medical insurance system, and, on the basis of trying out payment based on certain single disease entities, implement payment based on disease entities.

Objective:To investigate the effect of mycophenolate mofetil(MMF)on proliferation and apoptosis of cyst-lining epithelial cells in patients with autosomal dominant polycystic kidney disease(ADPKD),and to compare its effect with that of rapamycin(RAPA)in vitro.Methods: Primary cultured cyst-lining epithelial cells were treated with MMF and RAPA at different concentrations(0,0.005,0.05,0.5,5 ?g/ml)for 48 h or 72 h.The inhibitory effects of them on the cells were evaluated by MTT assay;the cell cycle distribution and apoptotic ratio were determined by flow cytometry.The morphological changes of cyst-lining epithelial cells were observed under transmission electron microscope.Results: Both MMF and RAPA significantly inhibited the proliferation of cyst-lining epithelial cells in a dose-and time-dependent manner.After 48 h treatment,the cells were blocked at S phase by MMF and at G0/G1 phase by RAPA.Both drugs induced cell apoptosis,with the maximal apoptotic rate being(5.53?0.27)% for MMF and(4.36?0.10)% for PAPA.Typical morphological changes of apoptotic cells were observed under electron microscope.Conclusion: MMF can effectively inhibit proliferation and induce apoptosis of cyst-lining epithelial cells,but its inhibitory effect is weaker than that of RAPA.

Thiols, which are components of many proteins and simple molecules, play an important role in the cellular antioxidant defense system. The quantitative determination of thiols is important in biochemistry and clinical chemistry. Fluorescent probes, which have its apparent advantages in sensitivity and, most importantly, in imaging thiols in vivo, even in single living cells, appear to be particularly attractive. In this review, we classify the fluorescent probes based on their different reaction mechanisms with thiols and summarize the recent progresses of thiols fluorescent probes with fifty-one

BACKGROUND:The differentiation of neural stem cells (NSCs) is a hot research. Whether brain-derived neurotrophic factors (BDNF) can induce the differentiation of NSCs into neurons has not been detailed studied. OBJECTIVE:To investigate the effect of different concentrations of BDNF on the differentiation of NSCs from adult rat hippocampus into neurons in the medium with epidermal growth factor. DESIGN:A controlled study. SETTING:Department of Human Anatomy, China Medical University. MATERIALS:The experiment was performed at the Neurotomia Laboratory of China Medical University in August 2007. NSCs isolated from hippocampus of adult SD rats were inoculated in a serum-free medium. Three clean adult SD rats (200-250 g each) were provided by Laboratory Animal Department of China Medical University. Dispositions to the rats were consistent with ethical standards of animals. Epidermal growth factor (EGF) and BDNF were bought from R&D Company. METHODS:①NSCs obtained from rat hippocampus were cultured in the serum-free medium containing basic fibroblast growth factor (bFGF), EGF and B27. ②Single cell clone was obtained via limited dilution for the fourth passage of cells. Identification of NSCs for the passage of cells from monoclonal spheres was performed by Nestin immunocytochemistry. Neurons and astroglial cells were identified by immunocytochemistry for neuron specific enolase (NSE) and glial fibrillary acidic protein (GFAP) a week after differentiation. ③Differentiation for the monoclonal spheres was done to appraisal the proportion of neurons. NSCs were divided for several groups containing 0 μg/L, 50 μg/L, 100 μg/L, 150 μg/L, and 200 μg/L groups according to the doses of BDNF. EGF was added in the media of each group. Immunocytochemistry for NSE was done a week later to count the positive cells. MAIN OUTCOME MEASURES:Proportion of neurons differentiated from NSCs.RESULTS:①NSCs immunocytochemical staining showed that Nestin was positive in monoclonal spheres, and NSE and GFAP were positive in differentiated cells. ②The proportion of differentiation from NSCs into neurons was significantly higher in groups treated with 50 μg/L and 100 μg/L BDNF compared to other groups（t=2.502-5.025, P < 0.05）, but there was no significant difference between 50 μg/L and 100 μg/L BDNF groups（P > 0.05）. Moreover, no significant difference was detected among 0 μg/L, 150 μg/L and 200 μg/L BDNF groups (P > 0.05). CONCLUSION:The optimal concentration of BDNF is 50 μg/L for differentiation from NSCs into neurons while the concentration of EGF is 20 μg/L.

Objective To evaluate the effect of maternal separation stress on the behavior of neonatal rd mice.Methods Neonatal rd mice were divided into maternal separation (MS) group (n=9) and control group (n=9).MS-stress was induced in the MS group by 4-hour-separation per day for 28 days.Open field test,elevated plus maze test,forced swim test and tail suspension test were used to evaluate the anxiety-like and depression-like behavior of the neonatal rd mice.Results The stay time and distance travelled of MS group in the central zone were 0.88％ and 28.17±5.65 cm,respectively,significantly shorter than that of the control group (2.61％,109.9±9.79 cm.P =0.04,P =0.001).Compared with the control group,the stay time in open arms of the MS group was significantly decreased (P<0.01),while the immobility time in forced swim test and tail suspension test of the MS group were 126.5±10.22 s and 21.56±6.83 s,significantly longer than that of the control group (77.75±16.83 s,P =0.02,7.37±3.22 s,P =0.03).Conclutions The 28-day maternal separation stress can significantly increase the anxiety-like and depression-like behavior in neonatal rd mice.

ObjectiveTo explore the screening and therapeutic efficacy of primary carnitine deficiency (PCD) in newborns and mothers.Methods164245 newborns and suspected mothers were investigated for PCD by tandem mass spectrometry (MS/MS).The overall epidemiology,prognosis,and follow-up of the screening program were investigated.ResultsTotally 55 suspected cases were identified at the primary screening stage.Four newborns and three mothers were confirmed as cases of PCD.The incidence rate of newborns was 1 ∶ 40076.All the patients showed normal growth and development during the follow-up.Blood free carnitine level was raised in all three mothers after treatment.ConclusionsScreening for PCD with MS/MS in newborns may represent a valuable procedure in preventive medicine by enabling early diagnosis and treatment before the onset of symptoms.This protocol is also highly efficient and applicable in diagnosis of mothers with PCD.

OBJECTIVE To implement the automatic management of medical equipment.METHODS Based on the platform of net,three layers of C/S were applied with database technology to realize one-time importation of the basic information and current information,it made the information function of quantity evaluation,quantity determination,schedule formation,automatic alarm,apparatus distribution list,statistical inquiry,collection analysis,and information feedback coming to true.RESULTS By using one year,the application of management information system of medical equipment could meet the requirement in scientific and standardized supply,and standard,application and management of medical equipment.CONCLUSIONS It can be able to improve the system efficiency,reduce the labor and mistakes,and also achieve the aim that cannot be done by manual labor.

Objective To explore the protective role of lipoxin A4 (LXA4) during early process of atherosclerosis formation in rats with juvenile metabolic syndrome (MS).Methods Rat models of juvenile MS were established with 3-week Sprague-Dawley (SD) rats fed on high-carbonhydrates and high-fat diet for 6 weeks.The other qualified ones were randomly grouped into model group,LXA4 low-dose group,LXA4 middle-dose group,and LXA4high dose group,and a control group fed with normal forage.The low,middle,high-dose groups were injected different doses of LXA4 daily,while the model group and control group were injected with the same dose of isotonic NaCl solution for 2 consecutive weeks.After 2-week medication,the visceral adipose tissue were isolated by laparotomy and heart blood collected by thoracotomy under anesthesia,followed the fixation of thoracic and abdominal aortas in the immobilized rats.The mRNA expression level of inflammation cytokines interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),C-reactive protein (CRP) in the adipose tissue were determined by semi-quantitative reverse transcription PCR (RT-PCR),respectively.Secretions of IL-6,and TNF-α in serum were determined by enzyme linked immunosorbent assay (ELISA).Immunocytochemistry was used to label endomembrane and middle-membrane of thoracic aorta,and endothelial cell layer in each group and the ratios of thickness of endomembrane and middle-membrane were compared.Results Compared with the control group,weight,body length and abdominal circumference of juvenile MS rats increased significantly (all P ＜ 0.05),and levels of fasting plasma glucose (FPG),triglyceride (TG),high density lipoprotein cholesterol (HDL-C) and insulin in models increased significantly (P ＜ 0.05).RT-PCR showed that the mRNA expressions of inflammatory cytokines IL-6,TNF-α and CRP in adipose tissue in model rats were upexpressed (all P ＜ 0.05).Compared with model rats,mRNA of IL-6,TNF-oα,and CRP in mid,high-dose rats were downexpressed (all P ＜ 0.05),mRNA of TNF-α in low-dose rat downexpressed (all P ＜ 0.05),and there were no significant differences between mRNA expressions of IL-6,CRP in low-dose and model rats according to statistics (all P ＞0.05).Compared with control group,inflammatory cytokines IL-6,TNF-α secreted in serum of model rats were increased significantly (all P ＜ 0.05),and inflammatory cytokines secreted in serum of intervention rats were decreased significantly compared with model rats (P ＜ 0.05).Pathological changes were as follows:HE staining:compared to model group,aortic tunica intima of model rats were remarkably thickened and endothelial cell layer was fragmented and incomplete,which was attenuated in each intervention group.The ratios of endomembrane and middle-membrane in rats:at the end of consecutive medication for 2 weeks,the ratios of endomembrane and middle-membrane in model rats were significantly greater than those of control group (P ＜ O.05),and the ratios of endomembrane and middle-membrane in high-dose intervention rats were significantly smaller than those of the model group (P ＜ 0.05),but still greater than control group,while there were no statistical differences between the ratios in low,middle-dose intervention rats and model rats (P ＞ 0.05).Conclusions The increasing inflammatory cytokines are involved in early process of atherosclerosis formation in rats with juvenile MS.LXA4 by reducing the expression of inflammatory factor level in adipose tissue,thereby reducing the inflammatory cytokines in serum,alleviate the damage of arterial wall.

Objective: To explore the relationship of plasma apelin and angiotensin II (Ang II) with hypertension and hypertension caused early renal damage in order to provide the information for hypertension treatment. Methods: A total of 671 participants were enrolled in this cross-sectional community investigation. All participants were above 30 years of age with local residency longer than 5 years and were divided into 2 groups: Control group,n=354 non-hypertension subjects and Hypertension group,n=317 patients with essential hypertension. The levels of apelin, Ang II, urine creatinine and urinary albumin were examined. The relationship between blood pressure and the ratio of urinary albumin to urine creatinine (UACR) and the relationship between blood pressure and apelin, Ang II were studied by Pearson correlation analysis and multi linear regression analysis. Results: Compared with Control group, Hypertension group had the lower levels of apelin and higher UACR, both P<0.01. The mean arterial pressure (MAP) was negatively related to Ln (apelin), positively related to Ln (Ang II), bothP<0.01. With adjusted gender, age and blood lipids, the above relationship still existed. In Hypertension group, the patients combining with the early renal damage had the lower level of apelin and higher level of Ang II, bothP<0.01. The relevant analysis indicated that Ln (UACR) was negatively related to Ln (apelin), positively related to Ln (Ang II), bothP<0.01. With adjusted gender, age, MAP and blood lipids, the above relationship still existed. Conclusion: The patients with hypertension or hypertension caused early renal damage have decreased apelin. Apelin is negatively related to Ang II, therefore, apelin might be used as a target for hypertension treatment in clinical practice.

Background: Helicobacter pylori (Hp) infection is closely related to the occurrence of gastric cancer and other gastrointestinal and extra-gastrointestinal diseases. Detection and eradication of Hp infection is of great importance for prevention and treatment of the related diseases. Understanding the local Hp infection status may provide a reference for formulating targeted strategy for management of Hp infection. Aims: To investigate the current status and influencing factors of Hp infection in health examination population and outpatients in Baoshan District, Shanghai. Methods: Residents of Baoshan District for physical examination (including 13C-urea breath test, 13C-UBT) in Shanghai Ninth People's Hospital (North Branch), Shanghai Jiao Tong University School of Medicine from Jan. 2017 to Jan. 2018 were enrolled.Also, local outpatients of the same hospital for 13C-UBT from Aug. 2017 to Aug. 2018 were enrolled. The results of 13C-UBT were used for the study of Hp infection status, and a questionnaire survey was conducted in outpatients for understanding the influencing factors of Hp infection. Results: Altogether 5 164 health examination subjects were included, and the prevalence of Hp infection was 36.3%. Of the 800 questionnaires conducted in outpatients enrolled, 746 valid questionnaires were collected for analysis. The prevalence of Hp infection in outpatients was 58.0%. Univariate analysis showed that occupation, married, alcohol drinking, frequently taking meals outside, high salt/fat diet, smoked food, and family history of Hp infection were identified as the influencing factors for Hp infection (P<0.05). Conclusions: The prevalence of Hp infection in health examination population in Baoshan District, Shanghai is lower than the national average, however, the infection rate of outpatients is still relatively high. Eating separately, less taking meals outside, abstinence of wine, and light diet might be helpful for preventing Hp infection and its spreading.