Objective: To summarize the existed problems and the relationship between the medical insurance and basic medical insurance policy, to find more reasonable payment mode to adjust with the medical insurance policy. Methods: On the basis of the endowment insurance implement experience, explore the payment mode of medical insurance. Results: It is very necessary to set the payment period of the basic medical insurance.

Objective: To explore the change of activities of the cardiac autonomic nervous system in the EMG biofeedback with the quantified index of heart rate variability(HRV). Methods: Various physiological signals such as ECG、EEG、EMG were recorded by Synchronous Multi-Signal Recording Biofeedback System, and HRV analysis was applied to the extracted ECG signals. Thirty healthy young men received the tests. Results:Compared with the resting state, when the subjects entered biofeedback state, the values of low frequency power, indicator of the sympathetic activity decreased while the values of high frequency power (indicator of the vagal activity) increased, and the values of low frequency power/high frequency power ratio, the marker of the sympatho-vagal balance decreased too. During the later treatment sessions (after 7-10 times treatments) the change exhibited statistical difference and achieved one stable level (low frequency power, baseline 3.98?0.21, 3.82?0.15, 3.93?0.16, 3.91?0.23, test state 3.55?0.32, 3.51?0.29, 3.93?0.16, 3.39?0.26, t=-6.85～-3.68,P

Objective: To study the effect of hyperthermia treatment on apoptosis of human gallbladder carcinoma cell line GBC-SD.Methods: Human cultured gallbladder carcinoma cell GBC-SD in vitro was heated for 1 hour at 40℃ and 43℃.Then 6h、12h、20h later GBC-SD cells were collected,respectively.The morphologic character was observed under the microscope,the biological character was ascertained by DNA electrophoresis,the percentage of the cell apoptosis and the alteration of cell cycle were detected by flow cytometry.Results: After 1 hour heated at 43℃,gallbladder carcinoma GBC-SD cells occurred the most obvious apoptosis in 12h and 20h.Typical apoptotic bodies appeared,and DNA Ladder was demonstrated on DNA electrophoresis.Apoptotic peak and the change of cell cycle were tested by the flow cytometry.Conclusion:One hour moderate hyperthermia treatment at 43℃ is the effective heat-dosage to induce human gallbladder carcinoma GBC-SD cell apoptosis. [

Objective To examine the interrelation between the cognitive deviation and loneli-ness levels of medical students and its influencing factors. Methods Totally 220 medical students in grade two of one medical school were selected by method of cluster random sampling. The data of the research were obtained through cognitive bias questionnaire (CBQ) and emotional-social loneliness questionnaire. Interrelation between the cognitive deviation type and condition of emotional-social lone-liness of medical students were analyzed by Pearson product-moment correlation two-tailed test. Multi-ple stepwise regression analysis was conducted by taking score of emotional-social loneliness as de-pendent variable and score of CBQ as independent variable. Differences in cognitive deviation and loneliness levels between rural and urban students as well as between students from single child family and students from non single child family were analyzed by independent-sample t test. Results Neg-ative cognitive deviation of depression-distortion type was positively correlated with medical students' emotional isolation (r=0.161, P=0.021),social isolation (r=0.266,P=0.000), emotional loneliness (r=0.340, P=0.000) and social loneliness (r=0.385, P=0.000). The regression equation was: score of emotional-social loneliness=27.165+1.908 (depression-distortion)+0.836 (depression-non distortion).Students from non single child family had higher scores than students from single child family in the perspectives of depression-distortion”(P=0.017), social isolation(P=0.001), emotional loneliness(P=0.016), social loneliness(P=0.000). Rural students had higher scores in the above four perspectives than urban students(P<0.05). Conclusions Negative cognitive deviation levels of medical students is positively correlated with emotion and social isolation conditions and loneliness experiences. Regres-sion analysis shows that unhealthy cognitive disposition and thinking mode probably are one of the im-portant reasons leading to medical students' stress disorder. Students from single child family and rural area may experience social loneliness more deeply and students from single child family have obvious cognitive deviation.

BACKGROUND:In order to promote the recovery of nerve function after peripheral nerve injury, we should try to accelerate the regeneration of injured nerve axons on one hand, and try to improve the accuracy of proximal and distal nerve docking on the other hand. OBJECTIVE:To explore the selective regeneration of nerve axons after peripheral nerve injury in models with crush injury and freeze injury. METHODS:Total y 110 healthy male Sprauge-Dawley rats, 8 weeks old, were selected and randomly divided into three groups. The rates received crush injury, freeze injury and normal control ed surgery on femoral nerve trunk. At 2, 3, 6 and 12 weeks after modeling, general behavioral examination was performed, and then pure blue and red fluorescence were used to label the wrong-way ingrowth saphenous nerve and correct ingrowth femoral nerve muscular branches respectively;retrograde labeling the motor neurons in order to observe the distribution and amount of tracer in spinal cord anterior horn;electrophysiological examination was performed at 8 weeks after modeling, and analyzed statistical y. RESULTS AND CONCLUSION:Rats from both crush injury group and freeze injury group displayed decreased motion radius of hind limbs after surgery, and the stretch function was limited;but with time prolonging, the functions were recovered. The motor evoked potentials could be observed at the quadriceps, and there was no significant difference between two groups (P>0.05). The number of neurons stained red in the spinal cord anterior horn was increased gradual y in both crush injury group and the freeze injury group under fluorescence microscope. The number of neurons stained red in the crush injury group was significantly higher than that in the freeze injury group (P<0.05), and the number of blue-stained and purple-stained neurons was decreased gradual y. The results suggest that keeping the perineurium intact can gain accurate docking in axon regeneration and the recovery of injured limb functions, even though the damaged range is large.

BACKGROUND:There is a high prevalence of spinal tuberculosis in developing countries. Beside systematic chemotherapy, there are stil some patients who need surgical treatment at certain phase of systematic treatment. However, there is no standard method for surgical treatment of spinal tuberculosis yet. OBJECTIVE:To systematical y evaluate the effect of anterior approach and posterior approach through consulting the literatures on the comparison between anterior approach and posterior approach for the treatment of spinal tuberculosis. METHODS:The PubMed database, Medline database, Elseveir database, Wanfang database and CNKI database were searched with the key words of“thoracolumbar tuberculosis, control ed randomized trial, RCT, anterior, posterior”in Chinese and English. The randomized control ed trials on the comparison between anterior approach and posterior approach for the treatment of spinal tuberculosis were included. The operative time, intraoperative blood loss, correction degree of Cobb angle, loss of Cobb angle at final fol ow-up, al ograft fusion time, total hospital stay and the excellent and good rate of the effectiveness were compared by Revman5.1 software. RESULTS AND CONCLUSION:A total of 1 438 articles were screened out, and final y 9 randomized control ed trials were included. The total number of patients was 692, in which 324 were treated with anterior approach and 368 were treated with posterior approach. The operative time of anterior approach of 46.25(40.23, 52.26) minutes was less than that of posterior approach;the intraoperative blood loss of anterior approach of 148.91(135.12, 1 625.70) mL less than that of posterior approach;the correct degree of Cobb angle of anterior approach of 2.40°(2.21°, 4.62°) was smal er than that of posterior approach;the loss of Cobb angle of anterior approach of 0.66°(0.41°, 0.91°) was larger than that of posterior approach;the total hospital stay of anterior approach of 0.34 (-0.32,1.01) days was less than that of posterior approach;the al ograft fusion time of anterior approach was less than that of posterior approach for 0.26 (0.18, 0.34) months;the number of cases with excellent and good effect of anterior approach was more than that of posterior approach for 1.18(-0.48, 2.85);there were significant differences in operative time, intraoperative blood loss, correct degree of Cobb angle, loss of Cobb angle at final fol ow-up and al ograft fusion time between anterior and posterior approaches (P<0.01). The results showed that there were significant differences in operative time, intraoperative blood loss, correct degree of Cobb angle, loss of Cobb angle at final fol ow-up and al ograft fusion time between anterior and posterior approaches for the treatment of spinal tuberculosis, but there were no significant differences in total hospital stay and surgical efficacy.

Objective To investigate the relation between the apotosis of B cells in the peripheral blood (PB) and the expression of interleukin (IL)-17 in patients with rheumatoid arthritis (RA).Methods The proportions of apoptosis of B cells in the PB of 80 patients with RA and 80 healthy controls were measured by flow cytometry.B cells in the PB of 20 RA and 20 healthy individuals were isolated by MACS and Western blotting was used to detect the Bcl-2 and Caspase-3 protein levels.IL-17 levels were detected by enzyme-linked immunosorbent assay (ELISA).T-test and linear regression were used to analyze the data.Results The proportions of apoptosis of B cells in the PB of patients with RA and healthy controls were (14±6)％ and (24±9)％ respectively.The rate of apoptosis of B cells in patients with RA was significantly less than healthy controls (t=2.737,P=0.021).The Bcl-2 protein level of B cells in the PB of patients with RA group was significantly higher than that of control group (26±10,12±6,P＜0.01).Conversely,the Caspase-3 protein level of B cells in the PB of patients with RA group was significantly lower than that of the control group (16±7,31±12,P＜0.01).ELISA detected elevated level of serum IL-17 in the patients with RA as compared with controls [(69±19),(27±10) pg/ml,t=4.631,P=0.014].There was a negative correlation between the level of IL-17 and apoptosis of B cells in patients with RA (r=0.36,P＜0.01).Conclusion The elevated bcl-2 and reduced caspase-3 of B cells in patients with RA further proves there is abnormal apoptosis of B cells in RA patients.There is negative correlation between the expression of IL-17 and apoptosis of B cells in patients with RA and IL-17 can inhibit B cell apoptosis.

Objective To investigate the expression of serum sHLA-G in systemic lupus erythematosus (SLE) patients and the association with the disease activity.Methods The serum concentration of sHLA-G in SLE patients and healthy controls was measured with enzyme-linked immunosorbent assay.Results Significant higher sHLA-G levels were detected in patients of SLE than control group (P＜0.01),The serum concentrations of sHLA-G in active SLE patients were markedly higher than stable SLE patients (P＜0.01).The expression level of sHLA-G showed positive correlations with SLE activity index (SLEDAI)(r=0.30,P=0.01).There was no correlation between sHLA-G levels and serum concentration of Anti-dsDNA,C3,C4 and Anti-ANA in SLE patients (P＞0.05).Conclusion The level of serum sHLA-G is significantly increased in SLE patients.Positive correlations are observed between sHLA-G levels and SLEDAI.These data indicated that sHLA-G may play certain roles in the pathogenesis and progress in SLE.

Objective To investigate the expression of helper T cells (Th)17/regulatory T cells (Treg) balance associated factors in rheumatoid arthritis (RA) patients and their correlation with serum midkine (MK).Methods A total of 60 RA patients were divided into active RA patients (n=32) and inactive RA patients group (n=28).MK level in sera was detected by enzyme linked immunosorbent assay (ELISA) in 60 patients with RA and 30 healthy controls (HCs).The fraction of CD4+CD25+FOXP3+ Treg cells and IL-17+CD4+ Th17 cells in RA patients and healthy controls were determined by flow cytometry (FCM), and the expreasion of Foxp3, RORγt, Signal transducer and activator of transcription (STAT) 3 and STAT5 mRNA were detected with real-time polymerase chain reaction (PCR).Results were evaluated using ANOVA followed by q tests for comparisons of Th17 population between active RA patients, inactive RA patients and HCs, t test was used for comparing of Foxp3, RORγt, STAT3, STAT5 mRNA between RA group and HCs.The correlations between serum MK concentration and peripheral Treg cells, Th17 cells, Foxp3, RORγt, STAT3, STAT5 mRNA were analyzed by Pearson's correlation analysis.Results The percentages of Treg cells from active RA patients, inactive RA patients and HCs were significantly different (F=129.6, P＜0.01), the percentages of Treg cells of active RA patients [(1.41±1.05)％] were lower than that of the inactive RA patients [(3.6±1.6)％;q =7.92, P＜0.05] and healthy group [(7.7±1.7)％;q=22.45, P＜0.05], and there was significant difference between healthy group and inactive RA group (q=14.53, P＜0.05).The percentages of Th17 cells of the three groups were also significantly different (F=36.3, P＜0.01),the percentage of Th17 cells of active RA patients [(1.84±1.01)％] was significantly higher than that of inactive RA patients [(0.71±0.28)％;q=9.59, P＜0.05] and healthy group (0.53±0.16)％ [(P＜0.05;q=1 1.10, P＜0.05], there was no significant difference between the inactive RA group and healthy group (q=1.51, P＞0.05).The expression of RORγt and STAT3 mRNA in RA patients was higher than that of healthy controls (t=5.84, P＜0.01;t=4.52, P＜0.01).The expression of Foxp3 and STAT5 mRNA in RA patients were lower than healthy controls (t=6.01, P＜0.01;t=2.18, P＜0.05).Serum MK values were correlated with STAT5 (r=-0.55, P＜0.01), but not with Foxp3, RORγt, STAT3 mRNA or the percentage of Treg/Th17 cells.Conclusion Serum MK expression and the percentage of Th17 cells increase, while the percentage of Treg cells decrease in RA patients.Serum MK values are negatively correlated with STAT5 mRNA which is associated with Th17/Treg balance.This may be important in the pathogenesis of RA.

Objective To observe the expression of small ubiquitin?related modifiers(SUMO)protein in normal cultured human lens epithelial cells(SRA01/04)and discuss regulation effects of SUMO protein on oxidative stress induced by high glucose. Methods The expression and local?ization of SUMO 1,2/3,4 was detected in normal cultured SRA01/04 cells through immunocytochemistry. The mRNA expression levels of SUMO 1?4 were examined by RT?PCR after the SRA01/04 cells treated with high glucose media at different concentrations and time points. Samples were grouped by medium concentrations(glucoses 5.5 mmol/L,12.5 mmol/L,25 mmol/L,50 mmol/L respectively for 24 h)and by treatment time(0 h, 6 h,12 h and 24 h respectively). After highly efficient transfection of GFP?SUMO2 into SRA01/04 cells,the survival and apoptotic rates of transfect?ed and un?transfected cells treated with high glucose was detected by CCK8 method and AV/PI double staining flow cytometry. Results The immu?nocytochemistry results showed that SUMO1,2/3,4 proteins were mainly located in the nucleus of SRA01/04 cells and part of SUMO2/3 was in the cytoplasm. RT?PCR results showed that compared with the low?glucose group,the mRNA expression of SUMO1?4 was increased along the increas?ing glucose concentration in the high?glucose group(P<0.05). Compared with 0 h,the mRNA expression of SUMO1?4 was enhanced at 6 h,12 h and 24 h(P<0.05)in the high?glucose group treated at 50 mmol/L concentration. Compared with the un?transfected cells,the survival rate was in?creased and the apoptotic rate was decreased in GFP?SUMO2 transfected cells in oxidative stress induced by high glucose(P<0.05). Conclusion SUMO protein was positively expressed in SRA01/04 cells and the expression of SUMO mRNA was affected by oxidative stress induced by high glu?cose.