Objective:To put forward rational suggestions of how to reduce the protest in medical insurance cases from two aspects:hospitals and medical insurance agencies, to provide reference for strengthen management of designated hospitals and Medical Insurance Center. Methods:Taking a tertiary hospital of Beijing as an example, summarizing the basic situation of protest in medical insurance and analyzing several kinds of cases, making thorough analysis of deep-seated reasons which caused the protest in medical insurance and finally put forward rational suggestions. Results: The protest in medical insurance is not only caused by hospitals, the Medical Insurance Center should also take certain responsibilities. Conclusion: Hospitals and Medical Insurance Center should all take corresponding measures to reduce the protest in medical insurance cases.

The expression of tissue factor (TF) on the surface can be called TF positive MP, which participate not only in thrombosis, but also in the invasion and metastasis of tumors. Therefore, this article will review the role of TF positive MP in patients with malignant tumors.

Peroxiredoxins(Prxs) are a family of antioxidant protein that have been identified in prokaryotes and eukaryotes. As antioxidants, Prxs protein contains an active site cysteine that is sensitive to oxidation by H 2 O2, eliminate active oxygen that exist in normal tissues and cells, protect cells from oxidative damage induced by reactive oxygen species ( ROS). Prxs protein is a known free radical scavenger, and has been shown to play a role in several diseases. In this review, recent advances on the study of Prxs protein family and tumor related diseases are reviewed, which is expected to provide new ideas for the diagnosis and treatment of the related clinical diseases.

Objective To assess the efficacy and safety of diclofenac sodium paste in the treatment of primary osteoarthritis(OA).Methods 54 patients with primary OA were divided into two groups.The experiment group received diclofenac sodium paste.The control group received diclofenac sodium(votalin) emulgel.Patient global assessment and topical pain assessment,physician global assessment and topical pain assessment were wrote down at baseline and after final application.Safety was assessed by evaluation of adverse events,vital signs,and irritation at the application site.Results There were no significant difference between experiment group and control group in patient global assessment,patient pain assessment,physician global assessment,and physician pain assessment.No serious gastrointestinal or renal adverse events were reported or detected by means of laboratory testing.Conclusion Diclofenac sodium paste is effective and safe in the treatment of primary OA.

Objective Toinvestigatetheclinicalfeaturesandsurgicalprognosisofmoyamoya syndromeinchildren.Methods Theclinicaldataof12childrenwithmoyamoyasyndromeadmittedto the 307th Hospital of People′s Liberation Army from December 2002 to October 2013 were analyzed retrospectively. Eleven of them underwent encephalo-duro-arterio-synangiosis (EDAS). A total of 550 children with moyamoya disease in the same period were used as a control group. The clinical characteristics and surgical efficacy of the children with moyamoya syndrome were summarized and concluded by comparing the clinical data of the two groups,including sex,age of onset,initial symptom,progress symptoms, Suzukiinstallments,imagingfeatures,andsurgicalefficacy.Results Themaleandfemaleratioof the children with moyamoya syndrome was 1∶2. Their mean age of onset was 12 ± 5 years old. There were significant differences in the initial symptom (cerebral infarction and cerebral hemorrhage )and disease progress between the children with moyamoya syndrome group and the control group (5/12 vs. 14. 5%[80/550], 3/12 vs. 61. 8%[340/550],and 5/12 vs. 8.7%[48/550],respectively;all P<0. 05). Within the follow-up period,of the 11 children underwent EDAS,7 cases had no further attack,and 4 cases were improved significantly. There was significant difference in the modified Rankin scale (mRS)between the beforeandaftersurgery(0[0,1]vs.2[1,2];P<0.05).Conclusions Theclinicalfeaturesofthe children with moyamoya syndrome have some differences with those with moyamoya disease. Timely and effective EDAS treatment may effectively prevent disease progression and improve the prognosis of patients.

Objective To determine the serum levels of B cell activating factor-receptor(BAFF-R)in patients with primary Sj(o)gren's syndrome(pSS)and investigate the role of BAFF-R in the pathogenesis of pSS.Methods The serum concentration of BAFF-R was measured by ELISA in 120 patients with pSS and 62 age-and sex-matched normal controls.Results The median level of serum BAFF-R was(692.7 ± 536.9)ng/L in pSS and (279.7 ± 186.9)ng/L in healthy controls.The serum level of BAFF-R in the pSS was significantly higher than normal controls(P ＜0.01).Higher level of BAFF-R was associated with higher level of IgG(r =0.429,P ＜0.01).Serum level of BAFF-R had no correlation with IgA,IgM,C3,C4,RF,ESR and CRP.BAFF-R level was markedly increased in patients with positive ANA,anti-SSA,anti-SSB antibody compared with those with negative antibody.Conclusion The serum BAFF-R level was significantly elevated and correlated with the level of immunoglobulin and autoantibodies.BAFF-R play certain role in the pathogenesis of pSS.

Felty syndrome is a rare disorder that involves rheumatoid arthritis,a swollen spleen,de-creased white blood cell count,and repeated infections.This article analyze the clinical characters of this disease.

Humans ; Infant, Newborn ; Male ; Meningitis, Bacterial ; physiopathology ; Seizures ; etiology ; Tuberculosis, Meningeal ; physiopathology

Objective:To analyze the benefit incidence and evaluate the implementation effects on catastrophic disease insurance under the New Rural Cooperative Medical System ( NRCMS) in Jilin Province and put forward sug-gestions to perfect the catastrophic disease insurance under NRCMS. Method: In-depth interviews with related staff were conducted to gain an understanding of the operating status of catastrophic disease insurance under NRCMS;cat-astrophic disease patient data of Jilin Province from 2013 were collected, with a comparative analysis of implementa-tion effects among nine districts;the benefit incidence was analyzed by means of the Sperman rank correlation analy-sis; Results: The policy of catastrophic disease insurance under the NRCMS exhibited sound implementation effects and played an important role in reducing the economic burden of catastrophic disease patients. The average individual expenditure decreased by 4336. 52 yuan, while the reimbursement rate increased by 11. 15% after NRCMS cata-strophic disease insurance reimbursements. Additionally, statistical analysis results showed that there was a weak cor-relation between benefit incidence and economic level, the benefit equality of catastrophic disease insurance under NRCMS was relatively good, but the benefit level of rich patients was slightly higher. Conclusion:The reimbursement scheme of catastrophic disease insurance under NRCMS should be refined and improved, and the benefit fairness of different districts must be ensured, thus achieving the goal of relieving the“poverty caused by illness” phenomenon.

Objective To clarify the diagnostic value of salivary gland ultrasonography in Sj(o)gren's syndrome (SS),and its correlation with the disease activity index and important organs involvement were analyzed.Methods A total of 116 patients with SS were involved,including 71 cases of primary SS and 45cases of secondary SS.Ultrasonography examination of major salivary glands was conducted for these patients,at the same time the clinical data including inflammatory parameters,the immunological parameter and the involved systems were collected.Ultrasonography examination was conducted in 49 cases as the control group.Use t test,x2test and analysis of variance for statistical analysis.Results The positive rate of salivary gland uhrasonography in SS (56/116,48.3％) was significantly higher than that of the normal control groups (1/49,2.0％),(The chi-square value was 32.57,P＜0.05),the sensitivity of salivary gland ultrasonography in primary SS (62.0％) was obviously higher than secondary SS (27％),(The Chi-square value was 13.75,P＜0.01).The specificity of salivary gland ultrasonography was 98％.The scores of salivary gland ultrasonography had shown positive correlation with the erythrocyte sedimentation rate,the levels of Immunoglobulin (Ig)G,and RF(r=0.234,0.353,0.176;P=0.002,0.000,0.013),and negative correlation with the white blood cell count (r=-0.292,P=0.000).Conclusion Salivary gland ultra-sonography provides additional evidence for the diagnosis of SS,particularly in primary SS groups.The scores of ultrasonography are correlated with inflammatory biomarkers,indicating that salivary gland ultrasonography is related to disease activity.