The poverty population definition for medical assistance was related to equity and precision,but still lacked theory and method in practice.The catastrophic and impoverishment health expenditure methods based on relative costs theory considered the family's ability to pay,which reflected the economic burden and poverty status of families.Meanwhile,they reflected the breadth and depth of poverty.Therefore,the theory and methods of catastrophic diseases relative costs could support the definition of catastrophic diseases for poverty population in China.

Objective To study the effect of Chinese traditional medicines on human hypertrophic scar fibroblasts in vitro,and determine their effective dosage.Methods Traditional Chinese medicines were cultured with human hypertrophic scar fibrob lasts(Fb)and normal dermal Fb,MTT colorimetr ic assay and cell growth curve were used to compare the influence of ethanol extracts fromChinese tradi tional medicines on the Fb growth activity and growth cycle.Results(1)Chinese gall markedly inhibited the proliferation of Fb derived from hyp ertrophic scar and normal skin,and was more effective on the former in a dose-dependent m anner(0～400?g /mL)during 72h of treatment.(2)The half inhibition concentration o f Chinese gall ethanol extract was 100?g /mL.The morphology of Fb did not change when its concentration was below 400?g /mL,as compared to colchicine(

Objective To determine the in vitro effects of the traditional Chinese medicines, berberine, matrine and baicalin, on the proliferation and lipid synthesis of human immortalized sebocyte SZ95, and to investigate their possible mechanisms of action on sebaceous glands at the cellular level. Methods Inverted microscopy was used to observe cell morphology and determine toxic concentrations of the compounds. The MTT method was adopted to examine the effects of different concentrations of berberine, matrine and baicalin on SZ95 cell proliferation after 24 h, 48 h and 72 h of incubation. Lipid contents in the SZ95 cells were labeled with Nile red and analyzed by flow cytometry. Results The toxic concentrations were 1?10-3 mol/L, 1?10-4 mol/L, 1?10-3 mol/L for baicalin, berberine and matrine, respectively. Berberine reduced sebocyte proliferation in a dose- and time-dependent manner, with an inhibitory concentration 50 (IC50) of 2.9?10-5 mol/L and 1.4?10-5 mol/L after 48 h and 72 h of incubation, respectively. When the concentration of matrine was 0.05). Lipogenesis of SZ95 cells showed a 26.9% increase with 1?10-3 mol/L matrine. Conclusions Our results indicate that berberine and baicalin can inhibit proliferation and lipid synthesis of SZ95 sebocytes in vitro, which suggests a possible clinical role in treating acne.

Objective To explore the methods and standards of catastrophic health expenditure for China,and improve the operability in defining those impoverished due to diseases.Methods 600 households with inpatients were randomly sampled from 12 villages of three townships in City M in Hubei province for household survey.Literature review and expert consultation methods were used to measure and determine the threshold of catastrophic health expenditure( CHE) of City M,with improvements made by grouping.Results In a uniform standard,the CHE occurrence of the income method and expenditure method is lower than the non-existence expenditure method and WHO method,verifying theoretically that the standard set for the former should be higher than the latter.In addition,the income method and expenditure method present differently in China.Standards set should vary with different measurement methods,maintaining approximate CEH expenditure for the same region.For the income method and expenditure method,the recommended benchmark reference is 25%,with an adjustable range of 35%~45%.Mutual verifications of these methods can further determine a rational CHE value.Conclusions The CHE methods support the definition of people impoverished due to diseases beyond their household payment capacity.Different thresholds however should be set for different methods,and the relative standards should be translated into absolute standards by grouping.

China ; Health Facilities ; statistics & numerical data ; Humans ; Occupational Health Services ; manpower

Acute Disease ; Humans ; Male ; Middle Aged ; Occupational Diseases ; therapy ; Plasma Exchange ; Propane ; analogs & derivatives ; poisoning

Objective To investigate the relationship between clinical types and related risk factors in female patients with post-adolescent acne.Methods Female outpatients with post-adolescent acne aged more than 25 years were enrolled from Department of Dermatology of Renji Hospital between January and October 2016.A questionnaire survey was conducted to investigate related risk factors for post-adolescent acne in the females.Skin lesions and clinical types were evaluated by dermatologists.Statistical analysis was carried out by t test for comparison of means between two groups and by chi-square test for comparison of ratios.Results A total of 312 female patients with post-adolescent acne completed the survey,including 268 (85.9％) with mild to moderate acne and 44 (14.1％) with severe acne,241 (77.2％) with persistent acne and 71 (22.8％) with late-onset acne,or 102 (32.7％) with comedonal post-adolescent acne (CPAA) and 210 (67.3％) with papular post-adolescent acne (PPAA).Survey on related risk factors showed that 121 patients reported seasonal factors and 59 (18.9％) patients became worse in summer,and spicy,sweet and fried foods can aggravate the condition in 131 (42％),93 (29.8％) and 85 (27.2％) patients respectively.Other risk factors such as premenstrual period (62.8％,196/312),psychological factors (51.6％,161/312) and exogenous chemical exposures (43.6％,136/312) were complained of by the patients.Furthermore,premenstrual period,diet and constipation were found to be more associated with PPAA compared with CPAA (x2 =4.523,4.068,3.910,respectively,all P ＜ 0.05).Exogenous chemical exposures,such as the use of cosmetics,exposure to polluted air environment and occupational hazards,were more associated with CPAA compared with PPAA,as well as with late-onset acne compared with persistent acne (x2 =6.579,9.057,both P ＜ 0.05).In addition,premenstrual exacerbation occurred more frequently in patients with persistent acne compared with those with late-onset ache (x2 =4.512,P ＜ 0.05).Conclusions The risk factors for the occurrence of female post-adolescent acne are very complex.Premenstrual exacerbation plays a major role in the aggravation of papular and persistent post-adolescent acne,diet and constipation are more associated with PPAA,and exogenous chemical exposures are still be considered in the aggravation of comedonal and late-onset post-adolescent acne.Thus,clinical types should be considered in the diagnosis and treatment of post-adolescent acne in females.

Objective To evaluate the application value of percutaneous transsplenic varices embolization(PTSVE)in the treatment of upper gastrointestinal hemorrhage in patients with schistosomiasis cirrhosis. Methods Sixteen schistosomiasis cir-rhosis patients(12 males and 4 females)with portal hypertension complicated with esophageal and upper gastrointestinal hemor-rhage were selected as the investigation subjects,all the patients had been treated by esophageal vein ligation and sclerothera-py,but with bleeding again post-operation. The patients were treated by PTSVE under the guidance of X-ray fluoroscopy. The success rate of PTSVE and the rate of complications were observed. In addition,the patients received PTSVE were reexamined with abdominal CT one month post-operation,and the degrees of varices were compared before and after PTSVE. Results Four-teen cases(87.50%)were successfully treated with PTSVE. Two cases(12.50%)failed,and one case had an abdominal bleed-ing 1 week post-operation. The abdominal CT showed the degrees of esophageal varices(P < 0.001),esophageal vein(P <0.001)and gastric varices(P < 0.001)were significantly decreased in the patients who received PTSVE one month after the op-eration. Conclusions PTSVE is a safe and effective method in the treatment of upper gastrointestinal hemorrhage in the pa-tients with schistosomiasis cirrhosis. PTSVE is especially suitable for the patients with severe liver cirrhosis,significantly bor-dered liver split,and bared main portal vein and even the branches.

Objective To explore the treatment method with combined dorsal flap based on the second toe and tibial flap for repairing the finger distal degloving injury.Methods From March 2008 to September 2011,our department chose treatment with combined use of free dorsal flap based on the second toe and contralateral second toe tibial flap for repairing finger distal degloving injury.The 11 fingers in 11 cases were treated and followed up after surgery.Results The flaps in 11 cases all survived; The donor site with skin grafting successfully healed; The follow-up was 4-15 months,averaged of 6 months.There was not obvious atrophy for the toe dorsal flaps in the finger back side and toe tibial flaps in the palm side.The finger pulp was full,the nails grew well and the appearance of the fingers was good.There was satisfactory sensory function restoration for finger pulp,two cases for S4,five cases for S3,three cases for S2 and 1 case for S1.The protective sensation was restored in the finger back for all the cases; the finger function was restored to normal; the foot donor site was healing well without scarring.Walking was completely normal.Conclusion It is an ideal treatment with combined use of free dorsal flap based on the second toe and contralateral second toe tibial flap for repairing finger distal.