Objective:To explore the usage of system dynamics analyzing the influencing factors of total health expenditure(THE),forecast the trends of total health expenditure based on the method of System Dynamics and put forward relative countermeasures.Methods:According to the literature and expert consultation,the population,elderly,GDP,government health expenditures,drug costs and the number of health workers per thousand population were the important factors for THE.These factors were incorporated into system dynamics model for total health expenditure and conducted the simulation.Results:Based on the examination,the simulation results highly corresponded to historical data (2002-2014) and the official forecast (2015-2020),which showed that the model had good stability and reliability.The simulation results showed that steadily increasing total health expenditure would reach 7 457.12 billion yuan in 2025.Conclusion:The system dynamics approach had superior characteristics to other projection methods in terms of stability and reliability.In order to control the irrational growth of total health expenditure,it needed to increase the prevention investment,decrease the incidence of chronic diseases;sustainably improve the reform of public hospitals,implement the basic drug system;change the income-oriented performance appraisal to realize the labor value of medical staffs.

Objective To investigate the immunomodulatory effect of black rice anthocyanin(BA) on biochemical indicators in blood and macrophages in rats.Method Twenty four female SD rats were randomly divided into 4 groups:control group,BA low,middle and high-dose groups(BAL 25;BAM 50;BAH 100 mg/kg bw).The control group was treated with normal saline,while BA groups were i.g.administered with defferent doses for 30 d.The blood biochemical indicators were detected by automatic biochemistry analyzer.The activities of lactate dehydrogenase(LDH),acid phosphatase(ACP),superoxide dismutase(SOD),and maleic dialdehyde(MDA) contents in peritoneal macrophage(PM) and alveolar macrophage(AM) were determined by biochemical methods.The ability of macrophages to phagocytose neutral red was measured by colorimetric method.Results The levels of urea nitrogen(UN),uric acid(UA),triglyceride(TG),total cholesterol(TC) and low density lipoprotein(LDL) in blood were reduced.The activities of ACP,LDH in PM were increased.and the activities of SOD in PM and AM were increased whereas MDA was reduced.The ability of PM and AM to phagocytose neutral red was strengthened significantly.Conclusion BA shows significant immunomodulatory effection blood biochemical indicators and macrophages in rats.

Objective To investigate the mental health and related factors for benign prostatic hyperplasia (BPH) patients. Methods 200 patients with BPH were investigate with the 4 dimensions of Quality of Life Scale for BPH patients (BPHQLS): worry about disease, psychological mood, social interaction and satisfaction. Results 85.50% of patients with BPH were in medium or poor mental health (standard score ≤80%). The total score of BPHQLS did not correlate with age, course of disease, and marital status (P>0.05), but correlated with degree of education and profession (P<0.05). Partial correlation analysis showed the total score correlated with the years of education (P<0.01). Conclusion Patients with BPH are in poor mental health. Degree of education is the main factors related with their mental health.

BACKGROUND: It has confirmed that angiotensin converting enzyme inhibitor benazepril can delay fibrosis of varied organs. However, whether benazepril has inhabited effect on peritoneal fibrosis in the process of peritoneal dialysis is poorly understood. OBJECTIVE: It is assumed that benazepril could inhabit peritoneal fibrosis of peritoneum with peritoneal dialysis, in addition, to compare the effect to other mehods. METHODS: All rats were randomly and evenly divided into 4 groups. There was no intervention in the control group; saline solution, and 20 mL 42.5 g/L Dianeal solution, was injected into rats in the saline solution and peritoneal dialysis groups; in the combination group, 20 mL 42.5 g/L Dianeal solution was injected combined with oral taken benazepril 20 mg/(kg·d). The intraperitoneal injection performed once a day, for 4 successive weeks. The ultrafiltration function was performed 4 weeks later. Meantime, Paraffin sections were cut and stained by Van Gieson to measure peritoneal thickness. RESULTS AND CONCLUSION: Two rats in the peritoneal dialysis group and 1 rat in the combination group were dead. The remained 37 rats were included in the final analysis. Compared to the control and saline solution groups, the ultrafiltration volume of the peritoneal dialysis and combination groups were obviously decreased (P_(all)< 0.05), especially notably decreased in the combination group (P< 0.05). Compared to the control group end saline solution groups, the peritoneal thickness was significantly elevated in the combination group, but not as much as in the peritoneal dialysis group (P < 0.05). In the long-term peritoneal dialysis rats, administration of benazepril can effectively protect the ultrofiltration function of peritoneum and delay the progression of peritoneal fibrosis.

OBJECTIVE To enhance the control and management of nosocomial infection in operating room in order to reduce nosocomial infection rate.METHODS We estabilished some effective sterilization and isolation measures and infection monitoring systems,strictly carried out sterile operation rule and created the qualified environment of operating room.RESULTS The nosocomial infection rate of cleaning wound was 0.25%,there was no specific nosocomial infection.CONCLUSIONS Strengthening management of nosocimial infection in operating room can effectively prevent it and reduce the infection rate of cleaning wound.

Objective·To evaluate the clinical value of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound in the diagnosis of uterine space-occupying lesion.Methods·A total of 75 patients with uterine space-occupying lesion were enrolled in this study from March 2015 to February 2016 at Hospital of Southwest Medical University.Patients received both two-dimensional ultrasound and four-dimensional color Doppler ultrasound to determine the location,number and nature of the lesions,as well as the clinical staging of malignant lesions,then the diagnostic accuracy was evaluated.Results·Among 75 patients,there were 26 cases with endometrial carcinoma,21 cases with hysteromyoma,16 cases with metropolypus,and 12 cases with uterine adenomyosis.The diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the uterine space-occupying lesion was 88.0％,which was significantly higher than that of two-dimensional ultrasound (64.0％) (P＜0.05).What's more,the diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the clinical staging of endometrial carcinoma was 88.5％,which was significantly higher than that of two-dimensional ultrasound (61.5％) (P＜0.05).Conclusion·Two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound is more effective to improve the diagnostic accuracy of uterine space occupying lesion and clinical staging of endometrial carcinoma in comparison with two-dimensional ultrasound,which will favor the clinical strategy for the treatment of uterine space-occupying lesion.

Objective To assess the CT image quality of the pure ground glass nodule(pGGN)in chest phantom by using different field of view(FOV)and matrix.Methods CT(Philips Brilliance 128 spiral CT)scans were performed on chest phantom containing 9 artificial pGGNs(diameter≥5 mm)in 3 different FOV (50 mm,150 mm,300 mm ),and were reconstructed in 2 different matrix(512×512, 1 024×1 024),standard kernel.Recorded the CT values and standard deviations (SD)of the nodules and surrounding regions in different FOV and matrix,and calculated the mean standard deviation(MSD),contrast noise ratio (CNR)and signal noise ratio (SNR),then compared the difference among them.Two radiologists assessed the image quality of the pGGNs in blind method respectively,then evaluated the coherence between them using Kappa testing.Results The coherence of 2 observers was substantial or almost perfect.No significant differences were found on MSD,CNR and SNR in different FOV (P value>0.05)when matrix was kept,whereas the visibility of the nodules improved with the FOV changing smaller.And there were significant differences all on MSD,CNR and SNR by using different matrix when FOV was kept.The MSD increased and the CNR,SNR decreased in high-resolution group.The visibility of the pGGNs was not improved obviously in high-resolution group.Conclusion The image quality of the pGGN(diameter≥5 mm)won’t be changed by using smaller FOV when matrix is kept ,but the visibility will be improved with the FOV changing smaller.When FOV is kept,the MSD increased and the CNR,SNR reduced in high-resolution group,but the visibility will not be improved obviously compare to the standard resolution group.

Objective To evaluate the clinical efficacy of Bilevel non -invasive positive air pressure ventila-tion(BiPAP)in the treatment of stable COPD patients with typeⅡrespiratory failure.Methods 36 patients had stable COPD with typeⅡrespiratory failure was treated with BiPAP.And observed the changes of clinical symptoms and arte-rial blood gases before and after the treatment.Results The Blood gas index[(7.28 ±0.04)vs (7.37 ±0.06)], heart rate[(116 ±11)times/min vs (85 ±10)times/min],breath rate[(26 ±4)times/min,(17 ±3)times/min], frequence of hospitalization[(3.50 ±0.89)times vs (0.23 ±0.11)times],and hospital days[(22.3 ±8.8)d vs (11.4 ±4.6)d]significantly changed after treatment(all P <0.01),the symptoms,including the shortness of breath, and chest distress improved greatly,and also the exercise tolerance were much better than patients did before treatment.Conclusion BiPAP is an efficient treatment method,and valuable for stable COPD patients with type Ⅱrespiratory failure.

OBJECTIVE: To investigate the preservation of the structure and function of the trachea and larynx, the management of laryngotracheal defect when trachea and larynx was involved. METHOD: To review the management and clinical results of 13 cases of thyroid papillary carcinoma with larynx and trachea involvement, the preservation of laryngotracheal structure and relative defect reconstruction of our department from 2007-2014. Those patients being performed total laryngectomy was excluded. 3 males and 10 females, aged from 46 to 67 years old with median age of 53 were included. Among them 8 cases were recurrent. The extent of the tumor foci was estimated with the help of computed tomography and laryngofiberoscope before surgery. Selective neck dissection, total thyroidectomy and related laryngotracheal resection was performed for the first time operation patient, while selective neck dissection, recurrent foci and related larynx and trachea resection was performed for those recurrent patients. Three kinds of modalities were applied to manage the laryngotracheal defect including to reconstruct with pedicled sternocleidomastoid clavicular periosteocutaneous flap, pedicled trapizius muscular flap and to preserve the remaining larynx and trachea and perform a stoma of larynx and trachea which repaired by a second-stage procedure. The patients were followed-up from half an year to 3 years. RESULT: Ten patients out of 13 decannulated while another 3 cases, 2 of which were performed local flap to reduce the stoma, wore tracheal tubes all time. CONCLUSION Either flap transfer or laryngotracheal stoma before second stage repair might preserve partial laryngotacheal anatomy and function in selected cases thus improve the life quality of the patients.
Aged ; Carcinoma ; surgery ; Carcinoma, Papillary ; surgery ; Female ; Humans ; Laryngectomy ; Larynx ; surgery ; Male ; Middle Aged ; Neck Dissection ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; Trachea ; surgery

ObjectiveTo investigate the expression of heme oxygenase-1 (HO-1) in lung tissue of mice with acute paraquat poisoning, and discuss its pathological mechanism.Methods Fifty-eight healthy male mice were randomly divided into control group (n = 8) and poisoned group (n = 50). The mice in poisoned group were lavaged with 20% paraquat (50 mg/kg), and those in control group with equal amount of normal saline. The mice were sacrificed on the day of experiment in control group, and those in poisoned group at 6 hours and 1, 3, 7, 14 days after poisoning. The lung tissue was harvested to observe the changes in pathology of lung with hematoxylin and eosin (HE) staining. The positive expression of HO-1 was determined with immunohistochemistry, and the protein expression of HO-1 was determined with Western Blot. The contents of superoxide dismutase (SOD) and malonaldehyde (MDA) were determined.Results The mice showed shortness of breath and signs of exhaustion 1 hour after poisoning, getting worse on 3-5 days, but returned to normal 14 days after poisoning. Under the light microscope, it showed that the control group had no significant pathological changes in lung tissue. One day after the ingestion, pulmonary alveolar structure disorder, obvious hemorrhage, edema and infiltration of inflammatory cells were found. At 3 days, the pathological changes in the lung tissue were more pronounced. They were less pronounced on 7 days, and inflammatory changes disappeared on 14th day, but alveolar structure disorder remained. Immunohistochemical test showed that HO-1 was seldom expressed in the lung tissue, and a little amount was expressed in the mucosal epithelial cells of the airway in control group. It was shown that inflammatory cell and endothelial were mainly distributed in the mucosal epithelial cells of airway 1 day after poisoning followed by a gradually decrease tendence, and came to normal level of control group 7 days after poisoning. It was shown by Western Blot that HO-1 (gray value) in lung tissue increased 6 hours after poisoning (2.438±0.467 vs. 0.475±0.167,P< 0.01), peaked at 1 day (9.200±0.940 vs. 0.475±0.167,P< 0.01), continued to increase till 7 days after poisoning, and it lowered to normal level thereafter (0.825±0.260 vs. 0.475±0.167,P> 0.05). The SOD activity (μU/L) in lung tissue was lowered 6 hours after poisoning, and it was significantly lower than that of control group (649.681±13.951 vs. 1 167.051±15.744,P< 0.01), and it continued to decrease up to 14 days after poisoning (859.733±121.079 vs. 1 167.051±14.744,P< 0.01). MDA content (μmol/L) in the lung tissue homogenate was elevated 6 hours after poisoning with significant difference compared with that of the control group (4.542±0.266 vs. 3.705±0.176,P< 0.01). It peaked on day 1 (5.956±0.281 vs. 3.705±0.176,P< 0.01), then it declined and reached normal level 3 days after poisoning (4.134±0.168 vs. 3.705±0.176,P> 0.05).Conclusion HO-1 expression was increased significantly in lung tissue of mice with acute paraquat poisoning, which may be considered as an important protection mechanism against paraquat poisoning.