Objective: To explore the impacts of demographic structure, environmental quality on household health care expenditures. Methods: Based on 2000-2010 inter-provincial panel data, the method of dynamic panel SYS GMM is used. Results:(1) The rise of elederly dependency ratio promotes residents’ health care expenditures; (2) the decline in juvenile dependency ratio is also the acceleration factor of health care expenditures; (3) the seriousness of environmental quality pollution expands the health care demand. Conclusion: To improve the health status residents, it is needed to implement the medical insurance system for the eldly, construct the health care insurance system for the children, besides, environment protection should be people oriented.

Objective: To investigate association between psychosocial factors and anxious and depressive disorders in patients with diabetes mellitus. Methods: 172 patients with type 2 diabetes were inquired with a self-administered questionnaire about their socio-demographic characteristics, perceived stress caused by the disease, coping styles, social support. At the same time, anxious and depressive disorders were assessed with HAD.Results:Among our sample, 35 (20.3%) patients with anxiety, 33 (19.2%) with depression. After adjusting for gender, age, marital status, educational level and income, multivariate logistic regression analysis found the following results. Perceived stress from "Worrying about to be harmed by the disease"(OR=1.76,95%CI 1.12~2.77),"Social/family crisis caused by the disease"(OR=1.85, 95%CI 1.18~2.92),"Worrying about declining in body/physical function"(OR=2.16, 95%CI 1.28~3.67), "Declined economic condition"(OR=2.03,95%CI 1.27~3.26)and "Negative coping styles"(OR=1.94,95%CI 1.26~2.97)were significantly associated with anxious disorders. The perceived stress from "Social/family crisis caused by disease"(OR=1.79, 95%CI 1.09~2.96), "Worrying about declining in body/physical function"(OR=2.89, 95%CI 1.59~5.24)and "Negative coping styles"(OR=1.95,95%CI 1.23~3.11)were significantly associated with depressive disorders, while patients "Taking avoidant measures"(OR=0.52, 95%CI 0.30~0.90)were less depressive disorders.Conclusion: Anxious and depressive disorders in patients with 2 type diabetes were significantly associated with patients' perceived stress from the disease and their coping styles.

Objective To explore the effects of interactive health education on the knowledge and behaviors of medicine use and the biochemistry indicators in hemodialysis patients. Methods Forty-eight eligible hemodialysis patients were intervened with interactive health education once every month. After three times'intervention, phosphorus, hemoglobin and hematocrit level were compared before and after the intervention. Results After the intervention, phosphorus, levels of hemoglobin and hematocrit were all significantly improved ( P<0 . 001 ) compared with that before the intervention . Conclusion The interactive health education can improve the knowledge and compliance behaviors in medicine use, serum phosphate and symptoms of anemia in hemodialysis patients.

Objective To explore the prevalence of poor behaviors and factors among patients with type 2 diabetes in urban areas of Guangzhou.Method Self-designed questionnaire was conducted among 369 patients with type 2 diabetes and factors on poor behaviour were analysed by binany logistic regression.Results Among 369 subjects with type 2 diabetes,80 cases(21.7%)currently smoked,41(11.1%)currently used alcohol and 65(16.9%)were lack of physical activity in leisure time.Multiple logistic regression analysis indicated that female,diabetes-related knowledge and health demands were significantly and negatively associated with smoking,alcohol use and the lack of physical activity; compared with unmarried cases,those who got married,divorced or loosed spouse significantly had the higher risk of smoking,one who got married had the lower risk of using alcohol; the cases with aged and high family income had the lower risk of lack of physical activity in leisure time.Conclusion There were a higher prevalence of poor lifestyle behaviors among these patients with type 2 diabetes,and there was a significant difference of the poor lifestyle behaviors in those with different characteristics,and the cases with good diabetes-related knowledge well encouraged them giving up the poor lifestyle behaviors.

Objective To screen out the tetrahydrobiopterin def iciency in patients with hyperphenylalaninemia by urinary pterin analysis. Methods Analysis of urinary neopterin (N) and biopterin (B) was done in 96 patients with hyperphenylalaninemia by high performance liquid chromatography. Combined BH4 loading test was performed for patients with abnormal urinary pterin profiles. Results Eleven patients were diagnosed as ha ving BH4 deficiency caused by 6 pyruvoyl tetrahydrobiopterin synthase deficiency. They had a much high N/B ratio(N/B:197?250) and a very low B percentage (1.0?0.8)%. Blood phenylalanine levels were decreased from (720 1 200) ?mol/L to (120 240) ?mol/L after taking BH4 tablets in 4 of 11 patients. Conclusion The incidence of BH4 deficiency among hyperphenylalaninemia is about 12%. Analysis of urinary pterin is feasible and effective in screening of BH4 deficiency.

Objective To analyze the effects of puerperium pelvic floor muscle training on pelvic floor muscle strength and its clinical significance. Methods One hundred postpartum women were included, with full-term singleton pregnancies and with complete follow-up records from Obstetrics Department of Peking University First Hospital between March 1, 2013 and October 31, 2013. Women with vaginal birth and cesarean birth commenced pelvic floor muscle training twice a day from 24 and 72 h after delivery, respectively. According to the different training frequencies, the subjects were divided into three groups: never-training group, occasional-training group (<6 times per week) and regular-training group (≥6 times per week). All patients received pelvic floor muscle strength measurement 6-8 weeks after parturition. And the strength of type Ⅰ and type Ⅱ pelvic floor muscle fiber was divided into 0, Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴgrade. The abnormal strength of typeⅠand typeⅡpelvic floor muscle fiber standed for the grades lower thanⅢ. We compared the general conditions, delivery modes and abnormal ratio of type Ⅰ and type Ⅱ pelvic floor muscle fiber among the three groups, analyzed the relativity between the level of pelvic floor muscle fiber strength and pelvic floor muscle training frequency, and analyzed the influential factors of pelvic floor muscle fiber strength. Statistical analyses were performed by one-way ANOVA, rank-sum test, Pearson χ2 test, Kruskal-Wallis nonparametric test, Nemenyi test, Spearman rank correlation analysis and multivariate Logistic regression analysis. Results There was no statistical difference in age, gestation at delivery, parity, body mass index before delivery, neonatal birth weight and delivery mode among the never-training group (21 cases), occasional-training group (30 cases) and regular-training group (49 cases) (all P > 0.05). There was no statistical difference in labor time of first, second and total stage and episiotomy rate among the vaginal birth cases of the three groups. The abnormal ratio of type Ⅰ muscle fiber strength among the three groups was 100% (21/21), 77% (23/30) and 6% (3/49), respectively, while that of type Ⅱ muscle fiber strength was 100% (21/21), 53% (16/30) and 20% (10/49), respectively. And there were significant statistical differences among the three groups (F=119.16 and 77.84, both P<0.01). Spearman rank correlation analysis indicated that the level of typeⅠand typeⅡmuscle fiber strength had a significant positive correlation with pelvic floor muscle training frequency (r=0.88 and 0.79, both P<0.01). Multivariate Logistic regression analysis showed that pelvic floor muscle training was an influential factor for pelvic floor muscle strength level (95%CI:0.000-0.193, P<0.01). Conclusions Puerperium pelvic floor muscle training can help enhance the tension force of pelvic floor muscle, might benefiting the postpartum recovery of pelvic floor muscle function.

AIM To study the expression of brain-derived neurotrophic factor (BDNF) in lymphocytes modified by BDNF gene and its effect on the proliferation and the H 2O 2-induced apoptosis of PC12 cells for the transfer of ex vivo therapeutic gene into central nervous system (CNS) tissue with atraumatic means. METHODS Recombined BDNF cDNA plasmid was transfected by LipofectAMINE into the packing cell line PA317 and G418-resistant clones with highest titer was selected. Rat lymphocytes were infected repeatedly with virus supernatant. The expression of BDNF in rat lymphocytes was assayed by FCM and immunohistochemistry. The proliferation of PC12 cells was evaluated by MTT assay. H 2O 2-induced apoptosis of PC12 cells was determined by PI stain flow cytometry. RESULTS BDNF expressed in rat lymphocytes genetically modified and the concentration of BDNF in the conditioned medium of engineered lymphocytes had a linear correlation with the proliferation of the PC12 cells. The supernatant of lymphocytes modified by BDNF gene decreased the apoptosis of PC12 cells induced by H 2O 2. CONCLUSION Rat lymphocytes genetically modified can express and secret active BDNF in vitro.

Objective To design the family support scale for adolescent patients with nephritic syndrome. Methods 192 adolescent patients with nephritic syndrome were selected in the pilot investigation, and then formed the first questionnaire. The reliability and the validity of the questionnaire were evaluated by the experts. Results The questionnaire involved 15 items and its reliability and the validity were satisfied. There was a positive correlation between the family support and the self-nursing degree. Conclusion The reliability and the validity of this questionnaire are both up to the demands, it can used to study the condition of family support for adolescent patients with nephrotic syndrome.

AIM: To compare the difference in serum prolactin levels and the concentrations of anti-infective factors of human colostrums between normal labor and cesarean section. METHODS: The serum prolactin levels were measured at 48 h, 96 h after parturition in 100 cases of normal labor and cesarean using radioimmunoassay. Furthermore, the levels of SIgA, IgG, IgM, C 3, C 4 were tested in 100 cases at the same time using the technique of immuno-turbidimetry. RESULTS: The serum prolactin levels in normal labor tested at 48 h after parturition were significantly different with that of the cesarean section group. But there was no significant difference in serum prolatin levels 96 h after parturition between the two groups. The levels of SIgA,IgG,IgM,C 3 and C 4 of the colostrum in the cesarean group were higher significantly than those of the normal group at 48 h after parturition. ( P

Objective To investigate the effects of individual and collective health education on hemodialysis patients with hyperkalemia. Methods Thirty hyperkalemia patients treated with maintenance hemodialysis from Mar. 2013 to Mar. 2014 were set as the control group, in which the patients were given pre-established individual health education by the hemodialysis nurse weekly. Another 30 patients of the same sort, as the experiment group, were treated with individual health education combined with collective health education weekly from Apr. 2014 to Apr. 2015. The two groups were compared in term of serum potassium before and after intervention. Result Serum potassium of the experiment group after the intervention were significantly lower than the control group and the experiment group after the intervention (P<0.001). Conclusion Individual health education combined with collective health education can change traditional indoctrination one-way communication to the two-way communication conversion , make the patients consciously change their incorrect dietary behaviors, and reduce the serum potassium levels in the hemodialysis patients with hyperkalemia.