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 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 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 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 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.

Objective To sift and optimize pulse width for electroacupuncture prevention and treatment of muscular atrophy. Method A model of lower limb muscle atrophy was made in 40 rats. They were randomized into groupsⅠ (no electroacupuncture),Ⅱ (a pulse width of 0.5 ms and a frequency of 2 Hz), Ⅲ (a pulse width of 100 ms and a frequency of 2 Hz) and Ⅳ (a pulse width of 200 ms and a frequency of 2 Hz). Points Zusanli (ST36) and Chengshan(BL57) were given electroacupuncture. Sciatic function index (SFI), gastrocnemius muscle wet weight ratio (GW), the cross-sectional area of gastrocnemius muscle fibers (GC), gastrocnemius muscle cell diameter (GD) and gastrocnemius muscle cell apoptosis index (AI) were used as indicators of therapeutic effect. Result Compared with group Ⅰ, SFI and GW increased significantly in groups Ⅲ and Ⅳ (P<0.05). Compared with groupsⅠ and Ⅱ, AI on the affected side decreased significantly in groups Ⅲ and Ⅳ (P<0.05). Conclusion The therapeutic effect of electroacupuncture is related to its pulse width. The pulse widths of 100 ms and 200 ms are significantly more effective than a pulse width of 0.5 ms from a conventional electroacupuncture device in preventing and treating muscular atrophy.

Objective To explore the correlations and status of self-management level and the quality of life of patients undergoing maintenance hemodialysis. Method The self-management behavior rating scale and World Health Organization Quality of Life-brief (WHOQOL-BREF) were used among 59 patients undergoing hemodialysis for the investigation. Results The score by WHOQOL-BREF was (40.56 ± 6.15) and that by the self-management behavior rating scale was (86.99 ± 16.41). The self-management level and the quality of life were positively correlated. Conclusion The measures including enhancing fluid intake, improving patient's compliance, encouraging them to actively participate in physical exercise and social activities can be done to improve their self-management and ultimately improve their quality of life.

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.

BACKGROUND:Stem celltherapy for renal ischemia-reperfusion injury has been the hot topics for many scholars. Its mechanism is very complex, which could not be explained by simple mechanism of stem cells differentiation. It is the result involving a variety of mechanisms. OBJECTIVE:To investigate the influence on immune cells during the bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury, then to preliminary summarize the immune regulation mechanism of bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury. METHODS:First, we established a model of renal ischemia-reperfusion injury in rats and, cultured and purified rat bone marrow mesenchymal stem cells in vitro. Then, the bone marrow mesenchymal stem cells were transplanted into the rat models. Using flow cytometry detection technology, we analyzed the proportion of CD4+CD25+regulatory T cells of rat spleen cells, discussed the effects on immune cells during the bone marrow mesenchymal stem celltherapy for renal ischemia-reperfusion injury, and then transferred the rat’s spleen cells to the nude mice which were subjected to renal renal ischemia-reperfusion injury. Renal function and renal histological changes of nude mice were assessed. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem celltransplantation could significantly inhibit the decrease of CD4+CD25+regulatory T cellof spleen cells in rats with renal ischemia-reperfusion injury. The transplantation of spleen cells from the above-mentioned rats to nude mice could obviously protect nude mice from renal ischemia-reperfusion injury, characterized by lower serum creatinine, blood urea nitrogen and renal tubule pathologic damage score. Therefore, bone marrow mesenchymal stem cells have protective effects on renal ischemia-reperfusion injury by regulating the immune system.