1.The Impact of the New Rural Cooperative Medical Scheme on Rural Medical Institutions
Jue YAN ; Tingting FAN ; Shasha JIAO
Chinese Medical Ethics 1995;0(04):-
Objective: Analyze the impact of NCMS(new cooperative medical scheme) on rural medical institutions,and give suggestions for the sustainable development of medical institutions and the NCMS.Methods: Collect and analyze the efficiency and the account materials of the county-level healthcare departments and the town-level health centers of Zhen'an County in 2003 and 2006.Results: The implementation of NCMS produced an effect on the increase of the outpatient medical service;the service quality of the county-level medical institutions and the town-level health centers needs to be enhanced in spite of the increase of in-patient medical service;the medical institutions' income increased,and the medical service fees increased rapidly;the expenditure per person and time rose sharply.Conclusions: Management mechanism of NCMS should be further developed,construction and supervision of the county-level medical sectors and the town-level health centers,especially supervision of the quality of medical sectors be enhanced;the payment system be changed to control the growth rate of medical expenses.
2.Effect of health education of schistosomiasis control with Yi-Han bilingual-ism
Zongliang FENG ; Shasha LI ; Jiao HUA ; Lin CHEN ; Zisong WU ; Congmin XU ; Yuhua LAI
Chinese Journal of Schistosomiasis Control 2017;29(1):77-79
Objective To evaluate the intervention effect of Yi?Han bilingual health education of schistosomiasis control. Methods Baimiao Village in Daqing Town,Xichang City,where Yi Nationality inhabited,was chosen as a pilot to carry out Yi?Han bilingual health education of schistosomiasis control from 2012 to 2015. The villagers and students in the pilot area were in?vestigated by questionnaires before and after the intervention to understand their awareness and correct behavior status on schis?tosomiasis control. Results After the intervention of Yi?Han bilingual health education of schistosomiasis control for 3 years, the awareness rate and the correct rate of behavior on schistosomiasis control of the villagers in the pilot area improved from 45.79%and 51.12%in 2012 to 97.80%and 98.78%in 2015. As for the students,the two rates mentioned above improved from 64.16%and 60.83%in 2012 to 100%and 98.89%in 2015 respectively,and all the differences between the rates before and af?ter the intervention were statistically significant( all P<0.01). Conclusion The intervention of Yi?Han bilingual health educa?tion of schistosomiasis control can obviously improve the knowledge awareness rates and the correct rates of behavior of the resi?dents and students in the gathering area of Yi Nationality.
3.Clinical characteristics and treatments of anti-coagulant rodenticide poisoning in children lacking of poisoning history
Jiao JIN ; Yongyan YAN ; Jing HUANG ; Shasha WU ; Yuanyuan TUO
Chinese Pediatric Emergency Medicine 2017;24(10):742-745
Objective To summarize the clinical characteristics,diagnosis and treatments of 50 chil-dren with no history of anti-coagulation rodenticide poisoning.Methods Fifty children lacking of poisoning history were admitted to our hospital from Feb 2011 to Dec 2015,who were due to hemorrhage and finally di-agnosed as rodenticide poisoning.The clinical manifestation,characteristics of blood coagulation dysfunction, toxicology screening results and treatments of 50 cases were retrospectively analyzed.Results All 50 cases were from rural area,and denied the history of taking rodenticide by mistake.The time from the onset to ad-mission to the hospital was from 1 d to 120 d,with an average of 11.66 d.Major clinical manifestations in-cluded:34 cases(68%)of skin ecchymosis,26 cases(52%)of epistaxis,10 cases(20%)of bleeding gums and 4 cases(8%)of hematoma at the injection site,with PT 20 to over 200 s and APTT 31 to over 200 s (maximal detection value).The children were diagnosed as rodenticide poisoning when one of brodifacoum, bromadiolone,and diphacinone-sodium or combination of brodifacoum and bromadiolone were detected from their blood specimens,with an concentration of 5 to 3 270 μg/L.The diagnosed children were intravenous dripped with specific antagonist vitamin K1 and the critically ill children were added fresh frozen plasma.All children recovered from hemorrhage within 24 hours after treatment.The level of PT,APTT was close to nor-mal after 3 to 7 days of treatment,and the using of vitamin K1 was accumulated about 30 to 70 mg.The chil-dren were given maintenance treatment of vitamin K1 for three months after discharge until the condition was stable.Conclusion Commonly used rodenticide has the characteristics of fat soluble, easy to accumulate, long incubation period,and long treatment period and so on.Children with no bleeding performance have the clinical tendency of acute bleeding,prolonged PT and APTT should be considered the possibility of rodenti-cide poisoning.Blood or urine samples should be screened for toxicology as soon as possible,and meanwhile children should be given antagonist treatment with special antidote vitamin K1 until the coagulation function is stable in normal range to avoid recurrence of the illness.
4.Serum level of ceruloplasmin in patients with different liver diseases in Jilin, China
Shasha WANG ; Fang HUA ; Yonggeng JIAO ; Eryun QIN ; Yixiao ZHI ; Mengyuan PANG ; Hongqin XU ; Xiumei CHI ; Junqi NIU ; Rui HUA
Journal of Clinical Hepatology 2020;36(9):2025-2029
ObjectiveTo investigate the serum level of ceruloplasmin in patients with different stages and etiologies of liver diseases. MethodsA total of 1077 patients with liver diseases who were hospitalized in Department of Hepatology, The First Hospital of Jilin University, from January 2012 to January 2018 were enrolled, and the serum level of ceruloplasmin was analyzed for the patients with different liver diseases. The Kruskal-Wallis H test was used to compare the level of ceruloplasmin between the patients with virus-related liver diseases with different liver functional states, and a Spearman correlation analysis was used to investigate the correlation of ceruloplasmin with other biomarkers. ResultsIn the Wilson’s disease group, 97.6% (41/42) of the patients had a serum ceruloplasmin level of <0.2 g/L and 881% (37/42) had a level of <0.1 g/L. In the non-Wilson’s disease group, 24.3% (251/1035) of the patients had a ceruloplasmin level of <0.2 g/L and 0.2% had a level of <0.1 g/L. There was a significant difference in the serum level of ceruloplasmin between the patients with virus-related liver diseases with different liver functional states, and the patients with chronic viral hepatitis, severe viral hepatitis, and viral hepatitis cirrhosis had a significantly lower level than those with acute viral hepatitis and virus-related liver cancer (P=0005, P<0.001, P=0.001, P=0.027, P<0.001, and P=0.001). In the patients without Wilson’s disease, serum ceruloplasmin was positively correlated with albumin and prealbumin (r=0.068 and 0.091, both P<0.05) and was negatively correlated with prothrombin time (r=-0.297, P<0.05). ConclusionCeruloplasmin often decreases significantly in patients with Wilson’s disease, with a slight reduction in patients with other types of liver diseases. For these patients, it should be determined whether the reduction in ceruloplasmin is caused by hepatocyte injury or the presence of Wilson’s disease.
5.Analysis of malnutrition status in pediatric acute lymphoblastic leukemia patients dur-ing the induced remission stage
Jing HUANG ; Jing LI ; Zhixu HE ; Jiao JIN ; Shasha WU ; Huiqun WANG
Chinese Journal of Clinical Oncology 2018;45(21):1096-1099
Objective: To investigate the nutritional status of children acute lymphoblastic leukemia (ALL) during induced remission stage. The effects of the disease itself, treatment, and complications of malnutrition were all analyzed. Methods: From the medical re-cords of children with ALL in the pediatric hematological department of the Affiliated Hospital of Guizhou Medical University, we col-lected basic information of the children; monitored the height and weight of the children on the first, 15th, and 33rd days of induced remission treatment; and calculated their body mass index (BMI), as well as results of laboratory tests such as serum albumin and se-rum prealbumin. SPSS 23.0 software was used for data analysis. Results: In 40 children with ALL, there were 16 cases of malnutrition on the first day of induced remission treatment accounting for 40%, 14 cases on both the 15th day and the 33rd day of treatment ac-counting for 35%. Among children with malnutrition, 4 cases of moderate to severe malnutrition occurred on the first day of treat-ment accounting for 25.0%, 9 cases on the 15th day accounting for 64.3%, and 12 cases on the 33rd day accounting for 85.7%. Com-pared with day 1 and day 33, the difference was statistically significant (P<0.017). In the induced remission period, the BMI on the first day was (15.98±2.17) kg/m2; on the 15th day, it was (15.65±2.20) kg/m2; and on the 33rd day, it was (15.66±1.92) kg/m2. The differ-ence between the three was not statistically significant (P=0.730). In the single-factor analysis of factors related to the nutritional sta-tus of children, infection, digestive system involvement, and serum albumin levels were related to the occurrence of malnutrition, and we performed multifactor analysis of these three factors. The difference between the level of infection and serum albumin and the oc-currence of malnutrition was statistically significant (P<0.05). Conclusions: During the induced remission, the malnutrition degree of some children with ALL was aggravated. Infection was a high-risk factor for malnutrition in children with ALL. The decrease in serum al-bumin level may indicate the occurrence of malnutrition. Dynamic monitoring of nutritional status in children with ALL is necessary.
6.Approach to the patient with pituitary metastases initially manifested as central diabetes insipidus
Feng GUO ; Shasha WANG ; Guijun QIN ; Zhizhen LI ; Yanyan ZHAO ; Xialian LI ; Lina WU ; Jiao WANG ; Ying ZHANG ; Gaofei REN
Chinese Journal of Endocrinology and Metabolism 2022;38(4):330-334
The data of 10 patients with pituitary metastases were retrospectively analyzed, including tumor origin, clinical features, imaging characteristics, diagnosis and differential diagnosis, treatment and prognosis. The results showed that the average age of 10 patients at the time of consultation was 62.0 years. Nine metastases were originated from lung cancer and one from breast cancer. All patients started with central diabetes insipidus, and some of them accompanied with hypopituitarism, as well as occupancy manifestations such as headache, blurred vision, etc. MRI showed abnormalities in the pituitary stalk and posterior pituitary, four of which showed characteristic " dumbbell-shaped" changes. Three patients with epidermal growth factor receptor(EGFR)-mutated lung adenocarcinoma revealed improvement in both primary lesion and pituitary metastases after targeted therapy.
7.Research Trend Analysis of Salvia Miltiorrhiza Based on SIOP Database
Zhiru XIE ; Shasha LI ; Leqi WANG ; Xue XIAO ; Weidong LI ; Jiao GUO
World Science and Technology-Modernization of Traditional Chinese Medicine 2018;20(9):1523-1530
Salvia miltiorrhiza, as one of the top grade herbs in Sheng Nong.s herbal classic, occupies promoting blood circulation function. The pharmacological of Salvia miltiorrhiza is obvious and the relevant research are extensive.However, there is still potential space for development. In this paper, the patents about Salvia miltiorrhiza were analyzed.The patents were collected from Patent Search Service System of"State Intellectual Property Office of the People's Republic of China". A total of 29 468 patent documents related to Salvia miltiorrhiza were retrieved. The health products and agriculture of Salvia miltiorrhiza has been well developed in recent years. The technology life cycle results show that the research of Salvia miltiorrhiza is in the growth stage. The analyze result shows that the application number were increasing year by year, and the increasing was sharp. The average number of patent applications of the top 10 patent holders is about 100, and the research focus is different. The distribution of patent technology in Salvia miltiorrhiza appears to be diversified, mainly in the fields of medicine, agriculture, chemical engineering and engineering. The results of high-quality and effective patent technology distribution show that classic research fields of Salvia miltiorrhiza are A61 K35 and A61 K36. The research of Salvia miltiorrhiza is still in rapid development stage, and involves a wide range of areas to be further studied and developed.
8.Experimental study on the effect of three-dimensional porous structures on the vascularization rate of artificial dermis
Rongwei TAN ; Xi LIU ; Yingying CHEN ; Mengqiang XU ; Yuanjun GUO ; Danyan WANG ; Jiamei LIANG ; Jiao LIU ; Shasha YUAN ; Wei FAN ; Xiangkun WANG ; Zhending SHE
Chinese Journal of Burns 2021;37(10):959-969
Objective:To explore the effects of orienting three-dimensional porous network (type A) and honeycomb briquette-shaped vertically penetrating three-dimensional porous network (type B) on the vascularization rate of artificial dermis.Methods:The experimental research method was used. The artificial dermis was composed of a double layer of silicone layer and scaffold layer. Based on the difference of scaffold layer, they were divided into type A and type B artificial dermis (type A dermis and type B dermis, for short) containing type A and type B structure, respectively. The type A and type B structures were prepared by gradient freeze-drying technique and physical pore-making technique, respectively. The micro-morphology of two kinds of dermis scaffold was observed by scanning electron microscopy. The porosity of two kinds of dermis scaffold was measured by the Pyrex method. According to the method of national medical industry standard, the hydroxyproline content in degradation liquids and their residues in two kind of dermis were determined after degradation at 4, 8, 13, and 24 h, reflecting the degradation rates of two kinds of dermis. According to the random number table, L929 cells were divided into type A dermis group, type B dermis group, negative control group, and positive control group. The positive control group was added with minimum essential medium (MEM) containing 5% dimethyl sulfoxide, The negative control group was added with high-density polyethylene extract, and the other two groups were added with the corresponding extract. At 24 hours after culture, the growth rate of L929 cells was detected by methyl thiazolyl tetrazolium, and the cytotoxicity was graded. L929 cells and human umbilical vein endothelial cells (HUVECs) were inoculated into pore plates with two kinds of dermis preinstalled. On 1, 4, 7, and 14 d after inoculating, the adhesion and growth of L929 cells on the surfaces of the two kinds of scaffolds were detected by immunofluorescence method. On 7 d after inoculating, the migration of the above two kinds of cells into the two kinds of dermal scaffolds was detected by immunofluorescence and hematoxylin-eosin (HE) staining. Three full-thickness skin defect wounds of 5.0 cm×5.0 cm were created on both sides of the back of three 6-month-old healthy male Ba-Ma mini pigs. According to the random number table, six columns of wounds were divided into type A dermis two-step method group, type B dermis two-step method group, and type B dermis one-step method group. The wounds in type A dermis two-step method group and type B dermis two-step method group were transplanted with type A or type B dermis respectively before, and with autologous split-thickness skin grafting later. The wounds in type B dermis one-step method group were transplanted in a synchronous procedure including type B dermis (without silicone layer) and autologous skin grafting simultaneously. The bleeding, exudation, and infection of the wounds on the back in type A dermis two-step method group and type B dermis two-step method group on the 7th day after the second transplantation and in type B dermis one-step method group on the 14th day after the first transplantation were generally observed. The area of autologous skin graft was measured by the transparent film grid method, and the survival rate of autologous skin was calculated. On 4, 7, and 14 d after the first transplantation, the inflammatory cells, fibroblasts (Fbs), and capillary infiltration into the scaffolds of the three groups were detected by HE staining. On 7, 14 d after the first transplantation, the vascularization of the scaffolds was further observed by immunohistochemistry. On 28, 90 d after the first operation, the degradation of the scaffolds of type A dermis and type B dermis was observed by HE staining. Data were statistically analyzed with one-way analysis of variance, independent sample t test, and Bonferroni correction. Results:A large number of round and oval micropores were evenly distributed on the surface of type A scaffold, and the cylindrical hole walls could be observed arranging in a parallel direction in the longitudinal section. The honeycomb briquette-shaped penetrating macropores on the surface of type B scaffold were arranged in an orderly matrix. The pore walls of the honeycomb briquette-shaped penetrating macropores were connected by micropores to form a network structure. The porosity of type A dermis was (93.21±0.72)%, which was similar to (95.88±1.00)% of type B dermis ( t=4.653, P>0.05). The degradation rates of type A dermis at 4, 8, 13, and 24 h were similar to those of type B dermis at the corresponding time point ( t=0.232, 0.856, 0.258, 7.716, P>0.05). At 24 h after culture, the proliferation rates of L929 cells in the type A dermis group, type B dermis group, and negative control group were significantly higher than those of the positive control group ( t=2 393.46, 2 538.27, 1 077.77, P<0.01). The cytotoxicity rating of cells in positive control group was grade 4, while that of the other three groups was grade zero. On 1, 4, 7, and 14 d after inoculation, both L929 cells and HUVECs proliferated in a time-dependent manner in two kinds of dermal scaffolds. The adhesion growth and proliferation rate of the two kinds of cells on the surface of type B dermis was higher than that of type A dermis. On 7 d after inoculation, both L929 cells and HUVECs covered the surface of type B dermis and migrated into one side of the silicone layer. However, the above two kinds of cells migrated slowly into type A dermis, and only a few cells were found on one side of the silicone layer. There was no bleeding, exudation, or infection in the wounds repaired by type A and type B dermis. The survival rate of autologous skin grafting of 6 wounds in each group was 100%. On 4, 7, and 14 d after the first operation, inflammatory cells, Fbs, and capillaries gradually infiltrated into the scaffold layer, and the cell infiltration rate from high to low was type B dermis one-step method group, type B dermis two-step method group, and type A dermis two-step method group. The scaffold in wound in the type B dermis one-step method group gradually collapsed on 28 d after the first operation, and completely degraded in 3 months after the first operation. The scaffold degradation rate of type A dermis two-step method group was similar to that mentioned above. Conclusions:The honeycomb briquette-shaped vertically penetrating three-dimensional porous network structure of type B scaffold can accelerate its vascularization process, which is beneficial to autogenous split-thickness skin in one-step procedure to repair full-thickness skin defects wound in Ba-Ma mini pigs. Compared with the "two-step method" of staged transplantation of type A scaffold and autologous split-thickness skin, and one-step transplantation has equal efficacy and can provide a better choice for wound treatment.
9.The Dynamics of Dopamine D2 Receptor-Expressing Striatal Neurons and the Downstream Circuit Underlying L-Dopa-Induced Dyskinesia in Rats.
Kuncheng LIU ; Miaomiao SONG ; Shasha GAO ; Lu YAO ; Li ZHANG ; Jie FENG ; Ling WANG ; Rui GAO ; Yong WANG
Neuroscience Bulletin 2023;39(9):1411-1425
L-dopa (l-3,4-dihydroxyphenylalanine)-induced dyskinesia (LID) is a debilitating complication of dopamine replacement therapy for Parkinson's disease. The potential contribution of striatal D2 receptor (D2R)-positive neurons and downstream circuits in the pathophysiology of LID remains unclear. In this study, we investigated the role of striatal D2R+ neurons and downstream globus pallidus externa (GPe) neurons in a rat model of LID. Intrastriatal administration of raclopride, a D2R antagonist, significantly inhibited dyskinetic behavior, while intrastriatal administration of pramipexole, a D2-like receptor agonist, yielded aggravation of dyskinesia in LID rats. Fiber photometry revealed the overinhibition of striatal D2R+ neurons and hyperactivity of downstream GPe neurons during the dyskinetic phase of LID rats. In contrast, the striatal D2R+ neurons showed intermittent synchronized overactivity in the decay phase of dyskinesia. Consistent with the above findings, optogenetic activation of striatal D2R+ neurons or their projections in the GPe was adequate to suppress most of the dyskinetic behaviors of LID rats. Our data demonstrate that the aberrant activity of striatal D2R+ neurons and downstream GPe neurons is a decisive mechanism mediating dyskinetic symptoms in LID rats.
Rats
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Animals
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Levodopa/toxicity*
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Dopamine
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Parkinsonian Disorders/drug therapy*
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Oxidopamine
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Dyskinesia, Drug-Induced
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Corpus Striatum/metabolism*
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Neurons/metabolism*
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Receptors, Dopamine D2/metabolism*
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Antiparkinson Agents/toxicity*