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 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

OBJECTIVE: To investigate the feasibility of utilizing pedicled sternocleidomastoid clavicular periosteocutaneous flap to reconstruct the laryngotracheal defect after tumor resection. METHOD: To review 6 cases of laryngotracheal defect resulting from resction of thyroid papillary carcinoma(4/6) or subglottic laryngeal carcinoma (2/6) (T1~2N1~2M0 , UICC,2002), laryngotracheal stenting was also employed in all cases. Half a year after surgery, the stoma was sutured if no local recurrence took place and safety was proved after tracheal tube had been obstructed for days. The follow-up time lasted from half a year to 3 years. RESULT: Four cases (4/6) were extubated successfully without event, one case could intermittently plug the tracheal tube. One patient couldn't breath with tracheal tube plugging. CONCLUSION To reconstruct the laryngotracheal defect with pedicled sternocleidomastoid clavicular.periosteocutaneous flap after tumor resection is feasible in selected cases and could get satisfactory clinical results either in respiration or phonation.
Back ; Carcinoma ; surgery ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Clavicle ; Head and Neck Neoplasms ; Humans ; Laryngeal Neoplasms ; surgery ; Larynx ; Neck Muscles ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Squamous Cell Carcinoma of Head and Neck ; Stents ; Surgical Flaps ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; 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.

Objective To study the effect of neuroepithelial cell transforming gene 1 (Net1) on the cellular radiosensitivity and underlying mechanism.Methods Real-time quantitative PCR was used to measure the variations in Net1 expression level upon irradiation.Radiosensitivity was analyzed by colonyforming assay after Net1-siRNAs.Net1-associated proteins were identified by co-immunoprecipitation.Results The Net1 mRNA level in the cells was increased significantly (t =-10.52,P ＜ 0.05) after irradiation.Compared to the control group,siRNA-mediated silencing of Net1 enhanced cell radiosensitivity (t =15.31,11.65,P ＜0.05).Net1 was found to interact with Ku70,Ku80 and DNA-PKcs under either normal conditions or after irradiation.Conclusions Net1 could protect cells from irradiation by interaction with DNA repair proteins in non-homologous end joining pathway.

A method was developed for the quantification of human growth hormone ( hGH ) by protein purification and isotope dilution-high performance liquid chromatography mass spectrometry ( HPLC-IDMS ) . The hGH was purified and fractionated by fast protein liquid chromatography ( FPLC ) , then hGH molecular weight was accurately determined by Fourier transform ion cyclotron resonance mass spectrometer ( FTICR-MS). The purified hGH was hydrolyzed and the separation was performed on an KINETEX C18 column (150 mmí2 mm I. D. , 2. 6 μm) with water ( containing 0. 1% TFA) and acetonitrile isocratic solution as the mobile phase at a flow rate of 0 . 2 mL/min and 40℃. The electrospray source was operated in the positive ion mode, and monitored in the multiple reaction monitoring ( MRM) mode. The measured hGH molecular weight by FTICR-MS was only 0. 31 Da difference from theoretical value. Three amino ( proline, valine and phenylalanine) were clearly separated by isocratic elution within 5 min. Under the optimized conditions, the content of hGH was 186 . 80 μg/g with a RSD of 0 . 5%. The detection results of hGH in international comparison by this method were consistent with the reference value, which validated the feasibility of the established method. The developed method is simple, practical, accurate, reliable and reproducible, and can be used for the hGH quantitation of pure hGH CRM to provide reference for the routine detection of hGH.

Objective To investigate the diagnostic efficiency of 18F-FDG PET/CT imaging for indeterminate thyroid nodules.Methods Sixty-eight patients (24 males,44 females,age:(52.8±10.58) years) with indeterminate thyroid nodules who underwent 18F-FDG PET/CT imaging from January 2006 to December 2012 were analyzed retrospectively.The imaging characteristic including clearity of boundary,uniform density,calcification,capsule,mean CT value,nodular size and SUVmax of thyroid nodules were evaluated.The gold standard was postoperative pathological results.Mann-Whitney u test,x2 test and ROC curve analysis were performed to investigate the diagnostic efficiency.Results Among 68 patients with indeterminate thyroid nodules,18 were malignant and 50 were benign according to pathological results.Uniform density,calcification,capsule (x2 =0.21,0.01,0.43,all P＞0.05) and mean CT value,nodular size (all AUCs＜0.5) could not differentiate benign from malignant thyroid nodules.However,whether the nodules had clear boundary was significant to differentiate benign from malignant nodules (x2=8.06,P＜0.05),and the sensitivity,specificity and accuracy were 55.6％ (10/ 18),80.0％ (40/50) and 73.5％ (50/68),respectively.The mean SUVmax of benign and malignant thyroid nodules was 3.16±1.84 and 8.53±7.09,respectively (u=-4.281,P＜0.01).AUC of SUVmax was 0.841 (95％ CI:0.726-0.955).According to the maximal Youden index(0.562),4.25 was chosen as the SUVmax threshold,and its sensitivity,specificity and accuracy were72.2％(13/18),84.0％(42/50) and 80.9％(55/68),respectively.Conclusion Among different characteristics of 18F-FDG PET/CT imaging,SUVmax of thyroid nodules plays an important role in the differential diagnosis of undetermined thyroid nodules,but CT image features have limited value.