China has not established the national long-term care insurance system, the long-term care expenses being mainly borne by the family, which leads to an unclear long-term care service utilization. This paper analyzes the impact of medical and pension insurance on the long-term care expenses for the Chinese disabled elderly by con-structing a two-part model based on the data of Chinese elderly longitudinal healthy longevity survey conducted in 2011 . The results showed that the long-term care expenditure of the urban elders with disabilities is significantly high-er than that of the rural ones. Although free public health insurance, the New Rural Cooperative medical insurance and endowment insurance have certain impact on the elderly long-term care expenditure, their effectiveness is differ-ent between the rural and urban areas. The urban elders' medical and pension insurance exerts influence on both the existence and the amount of the long-term care expenses. However, the rural elders' medical and pension insurance only have impact on the existence of the long-term care expenses, but the effect is not significant. It is suggested that China has to strengthen medical and pension insurance and build long-term care insurance system to lighten the finan-cial burden of the families of elders with disabilities.

Objective To explore the application value of 256 slice helical multi phase CT scan-ning and three-dimensional reconstruction in the diagnosis of malignant tumor of colorectal obstruction. Methods Using 256 slice spiral CT scanning and three-dimensional reconstruction of multi period in 42 ca-ses of malignant tumor patients with colorectal obstruction, the results and pathological results were analyzed and the postoperative stage.Results Forty-two cases of malignant tumors of colorectal obstruction, 256 slice spiral CT could well reflect the situation of location, range, degree, peripheral intestinal lymph node and distant metastasis, CTA could show the tumor supplying artery and branch sources, on the tumor loca-tion and overall accuracy.Conclusions 256 layer spiral CT scan and three dimensional reconstruction technology is accuracy for clinical diagnosis on malignant tumor of colorectal obstruction.

The determination and characterization of solid drug form polymorphisms plays an important role in drug quality control, selection of the production process and clinical efficacy evaluation. Vibrational spectroscopy is a powerful method for the characterization of drug polymorphisms. In this paper we review recent research and application advances in the polymorphic characterization of active pharmaceutical ingredients (APIs) and drug cocrystals/salts by using Fourier transform infrared (FTIR) and Raman spectroscopy to elucidate the characteristics of APIs and drug complexes. This may provide theoretical support for structural analysis during the development process for drugs.

Objective: To evaluate the value of multi slice computed tomography (CT) in differential diagnosis of renal clear cell carcinoma and renal papillary carcinoma. Methods: The CT images of 47patients with renal cell carcinoma (RCC) were reviewed. The RCC patients were divided into 2 groups pathologically, including 37 cases of clear cell RCC and 10 cases of papillary RCC. Plain scan and three phase (corticomedullary, nephrographic and excretory phases) CT were performed in all patients. Age and sex of patients, tumor size, enhancement degree and pattern (homogeneous, heterogeneous and predominantly peripheral), the presence of calcification or cystic degeneration (necrotic or hemorrhagic areas within the tumor) and tumor spreading (including perinephric change, venous invasion and lymphadenopathy) were compared between the 2 subtypes. Results: The degrees of enhancement were significantly different between the 2 subtypes in the corticomedullary, parenchymal and excretory phases (P<0.05). Necrosis and cystic degeneration were more evident in the clear cell RCC than in papillary RCC regardless of tumor size (P<0.05). A hypervascular pattern (higher tumor enhancement after contrast material injection due to higher vascularity) was noted in 21.6% of clear cell RCC cases and in 10% of papillary RCC (P<0.05). Half of the clear cell RCC and 2.7% of papillary RCC patients showed homogeneous enhancement (P<0.05). Calcification was evident in 21.6% of clear cell RCC patients and 20% of papillary RCC patients. Conclusion: The degree of enhancement is the most valuable parameter for differentiation of clear cell RCC and papillary RCC. The presence of cystic degeneration, hemorrhage, vascularity and enhancement patterns can also contribute to the differentiation of the 2 subtypes.

Since the concept of "artificial intelligence" was introduced in 1956,it has led to numerous technological innovations in human medicine and completely changed the traditional model of medicine.In this study,we mainly explain the application of artificial intelligence in various fields of medicine from four aspects:machine learning,intelligent robot,image recognition technology,and expert system.In addition,we discuss the existing problems and future trends in these areas.In recent years,through the development of globalization,various research institutions around the world has conducted a number of researches on this subject.Therefore,medical artificial intelligence has attained significant breakthroughs and will demonstrate wide development prospection in the future.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunoglobulin D ; Male ; Middle Aged ; Multiple Myeloma ; classification ; pathology ; Retrospective Studies

Child ; Humans ; Liver Diseases ; Mitochondrial Diseases

Objective: To evaluate the repair method and its curative effects on defects and joint instability in elderly patients with recurrent soft tissue sarcoma around the knee after wide excision. Methods:Our study included 6 elderly patients with limb sal-vage and effective preoperative chemotherapy. These patients underwent extended resections, including internal or lateral articular cap-sule and collateral ligament excisions. Owing to polyleptic soft-tissue sarcoma around the knee, formed soft-tissue defects, and joint in-stability, collateral ligament and/or partial articular capsule was reconstructed using #5 Ethibond sutures. Simultaneously, soft-tissue de-fects around the knee were repaired by composite-wide pedicled fasciocutaneous flaps or medial head of gastrocnemius muscle flaps of the leg. The maximum flexion angles of the knee (MFKs) were observed and statistically tested before and during surgery, with a fol-low-up period of 6 months. Results: The immediate stability of the joints and complete coverage of the soft tissue defects were achieved during the surgery. The MFKs during preoperative treatment, intraoperative treatment, and six-month follow-up were 115.0° ± 7.8°, 101.7° ± 9.3°, and 104.8° ± 10.2°, respectively, with significant differences between the preoperative and intraoperative MFKs (t=2.68, P<0.05). By contrast, no difference existed between the intraoperative and six-month follow-up MFKs (t=0.55, P>0.05). Conclu-sion:This repair method can be applied to elderly patients with polyleptic soft tissue sarcoma around the knee by using simple, fast, and reliable surgical techniques for the reconstruction, stability, and repair of soft tissue defects in the knee joint.

AIM:To evaluate the role of inhaling N 6-phenyl-2R-isopropyl-adenosine (R-PIA) on the airway resistance and pulmonary compliance of experimental asthmatic guinea-pigs. METHODS: Experimental model of asthmatic guinea-pigs were made. Inhaling R-PIA 5 mg/mL( 5 mg R-PIA in 1 mL 0.9% saline). The airway resistance, pulmonary compliance and NO- x, cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP),tumor necrosis factor (TNF) in bronchoalveolar lavage fluid (BALF) were observed. RESULTS: Compared with asthma group, after inhaling R-PIA, the airway resistance of experimental asthmatic guinea-pigs increased ( P 0 05). CONCLUSION: Inhaling R-PIA could constrict the airway of experimental asthmatic guinea-pigs.

Objective To investigate the role of PI3K/Akt pathway in mitomycin(MMC) induced apoptosis of liver stem cells.Methods Rat liver stem ceils were stimulated with MMC,and the effect of MMC on the apoptosis rate of WB-F334 cells at different time points(6,12,24 h),as well as the effects of different concentrations of (0.2,0.4,0.6,0.8,1.0 mg/mL) MMC on the cytotoxicity of WB-F334 cells were evaluated;moreover,cells were treated with p38 MAPK inhibitor and PI3K/Akt inhibitor,and the roles of MAPK and PI3K/Akt signaling pathway in MMC mediated apoptosis of WB-F334 cells were explored.Results The apoptosis rate of the MMC-treated WB-F334 increased with time(P＜0.05).Compared with the un-treated control group,different concentrations of MMC had obvious cytotoxicity on liver stem cells,and the cytotoxicity increased with concentration.Western blotting results showed that Akt and MAPK in WB-F334 cells were significantly phosphorylated 15 min after MMC stimulation;the degree of phosphorylation decreased with time,and phosphorylation disappeared after 60 min,suggesting that the p38 MAPK,PI3K/Akt pathway can be activated by MMC;furthermore,when p38 MAPK inhibitor was added to MMC treated cells,the apoptosis rate of p38 MAPK inhibitor treated cells showed no significant difference compared to the un-treated cells(P＞0.05),indicating that the MAPK pathway had no significant effect on MMC induced WP,-F334 cell death;however,when the PI3K/Akt inhibitor(API-2)was added,the apoptosis rate of API-2 treated cells was significantlv decreased compared to the un-treated cells(P＜0.05),indicating that the PI3K/Akt pathway had a significant effect on MMC induced apoptosis of WB-F334 cells(P＜0.05).Conclusion Stimulation of MMC can induce apoptosis of hepatic stem cells WB-F334 through the activation of the PI3K/Akt signaling pathway.