Objective To investigate the potential factors that may be associated with clinical significant endoscopy findings (CSEF) and the characters of the appropriate patients for upper endoscopy.Methods Information of the out-patients was collected from the questionnaires that were performed before undergoing upper endoscopy from 26 September 2011 to 23 December 2011,including demographics characteristics,symptoms,gastroesophageal reflux disease questionnaire (Gerd Q) score,comorbidities,medication and purpose for upper endoscopy.The analyses were performed by Logistic regression to find the potential factors that were associated with CSEF.Results A total of 942 cases were enrolled.There were 471 (50.0％) patients with dyspepsia and reflux symptoms,300(31.8％)patients with dyspepsia and without reflux symptoms,and 86(9.1％)patients with reflux symptoms and without dyspepsia.Sum to 325 (34.5％) patients were diagnosed with CSEF,119(12.6％) with erosive esophagitis,28(3.0％) with Barrett esophagus,102 (10.8％)with peptic ulcers,66 (7.0％) with gastric dysplasia,and 13 (1.4％) with upper malignancy.Multivariate Logistic regression analysis showed that men (OR=1.677,95％CI:1.148 to 2.451),older age (OR=1.032,95％CI:1.021 to 1.044),alcohol intake (OR=1.761,95％CI:1.068 to 2.903),Gerd-Q score increase (OR=1.079,95％ CI:1.003 to 1.160),and presence of acid regurgitation (OR=1.659,95 ％CI:1.143 to 2.408) were significantly associated with increasing risk of diagnosis for CSEF,while taking proton pump inhibitors (OR=0.298,95％CI 0.109 to 0.818)was associated with lower possibility of detection.Conclusions Factors such as male,older age,alcohol intake,Gerd-Q score increase,presence of acid regurgitation and taking proton pump inhibitors,may have a certain significance for screening out patients and further improving the cost efficiency of gastroscopy.

Objective:The paper aims to evaluate the impacts of the urban residents’ basic medical insurance on the medical treatment and preventive care services utilization through quantitative evaluation. Methods:The China Health and Nutrition Surveys ( CHNS) Data collected from 2006 to 2011 were used to compare the difference between medical treatment and preventive care services utilization adopting the difference-in-difference method and the Probit model. The control group urban residents did not participate in the basic medical insurance while their treatment group participated. Results:The medical treatment and preventive care services utilization were more for the treat-ment group than they were for the control one. The age, education level, annual per capita income and hypertension influenced the medical services utilization, and the annual per capita income was a protective factor. The age and ed-ucation level also influenced the preventive care services utilization. Conclusion: The urban resident basic medical insurance plays an important role in the medical treatment and preventive care services utilization. Meanwhile, this factor continuously enhanced the coverage and the per capita income protection for medical services.

Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

10.3969/j.issn.1000-3606.2013.06.024

10.3969/j.issn.2095-4344.2013.23.015

Aim To study the absorption kinetics of se-ries molecular weight 5-ASA-mPEG in rats intestine. Methods The in situ intestinal absorption property of 5-ASA-mPEG in rats was investigated by means of sin-gle-pass perfusion, and HPLC method was established to determine the drug concentration in the perfusate. Results The drug concentration and the site of intes-tine segments had little effect on the drug absorption constant ( Ka ) and apparent absorption coefficient (Papp). The perfusion flow rate and the variable mo-lecular weight of 5-ASA-mPEG could significantly af-fect the Ka and Papp. Conclusion 5-ASA-mPEG can be absorbed at all segments of the intestine of rats and has no specific absorption site. It is preliminarily in-ferred that the absorption mechanism of 5-ASA-mPEG is passive transportation. The intestinal absorption of 5-ASA-mPEG shows a downward trend with the increase in molecular weight. The results shows that the modifi-cation of 5-ASA by PEG can effectively inhibit the in-testinal absorption of mesalazine.

Background and purpose:miR-17-92 gene cluster overexpression has been observed in various cancers, such as lung cancer, liver cancer, gastric cancer and prostate cancer. In this study, we established the stable cell line overexpressingmiR-17-92 to explore the inlfuence ofmiR-17-92 on the migration, invasion abilities and cisplatin resistance of the prostate cancer DU145 cells.Methods:miR-17-92 overexpression vectors were constructed. DU145 cells were infected with the viral supernatants produced by Phoenix A packaging system. Real-time lfuorescent quanti-tative polymerase chain reaction (RTFQ-PCR) was conducted to detect the expression level of miR-17-92 in the cells. The migration and invasion abilities were measured by a real-time xCELLigence system. The scratch healing assay was carried out to investigate the migration abilities. The expression of integrin β1 was detected by Western blot, and the activities of matrix metalloprotein-2 (MMP-2) and matrix metalloprotein-9 (MMP-9) were measured by gelatin zymography experiment. The cell growth of the two cell lines after the treatment of cisplatin was detected by a real-time xCELLigence system. The mRNA expression ofERCC1 was measured by RTFQ-PCR. Western blot was conducted to investigate the protein expressions of ERCC1, ERK1/2 and pERK1/2.Results:DU145-miR-17-92 cells migrated faster than DU145-control cells during the 24 h continuous monitoring (P<0.01). The scratch healing assay indicated that DU145-miR-17-92 cells migrated from the edge towards the scratch center faster than DU145-control cells. DU145-miR-17-92 cells invaded through matrigel markedly faster than DU145-control cells (P<0.01). The protein expression level of integrin β1 and the MMP-9 activities in DU145-miR-17-92 cells were increased than those in DU145-control cells. After the treatment of cisplatin, DU145-miR-17-92 cells grew faster than DU145-control cells, presenting cisplatin resistance (P<0.01). The phosphorylation of ERK1/2 in DU145-miR-17-92 cells was constantly at a high level regard-less of the treatment of cisplatin. Compared with DU145-control cells, the expression of drug resistance-related gene ERCC1 was dramatically increased in DU145-miR-17-92 cells after the treatment of cisplatin.Conclusion:miR-17-92 overexpression increases the migration and invasion abilities of the prostate cancer DU145 cells, which is associated with the upregulated expression of integrin β1 and the increased activity of MMP-9. Besides,miR-17-92 overexpression enhances the cisplatin resistance of DU145, which is correlated with the increased phosphorylation level of ERK and the upregulated expression of ERCC1 at both the mRNA and protein levels.

Objective To explore the relationship between expected drop and postpartum depression,analysis of influence factors of postpartum depression.Methods Chinese version of Postpartum Support Questionnaire and Edinburgh Postnatal Depression Scale were used to investigate 411 puerpera of 42-56 days postpartum by the convenience sampling method.Results The incidence rate of postpartum depression was 17.03％ (70/411).The correlation coefficient r between the actual situation of postpartum social support and the score of each dimension and the score of Edinburgh Postpartum Depression Scale was 0.157 to 0.247 (P ＜ 0.01).The correlation coefficient r between the postpartum social support expectation drop and the Edinburgh Postpartum Depression Scale score was 0.173 to 0.230 (P ＜ 0.01).Regression analysis showed postpartum depression was related to emotional support,nursing mode,registered permanent residence and gender expectations for baby.Conclusions The positive rate of postpartum depression is still higher.How to reduce the incidence of postpartum depression is still a problem to be solved.According to the characteristics of social support and maternal postpartum to evaluate the importance of targeted social support can reduce the incidence of postpartum depression.

Objective To observe the clinical efficacy of Tiao Ren Tong Du (regulating the Conception Vessel and unblocking the Governor Vessel) needling method plus bloodletting at the Jing-well points in treating post-stroke spastic state. Method Sixty-seven eligible patients were randomized into a group to receive Tiao Ren Tong Du needling plus bloodletting at the Jing-well points (treatment group) and a rehabilitation group (control group). For the two groups, the treatment was given once a day, 6 times as a treatment course, for 4 courses in total. The Modified Ashworth Scale was used to evaluate the spasticity intensity, and the Patient Reported Outcome (PRO) for post-stroke spastic hemiplegia was used to measure the patients from the following four aspects:subjective symptoms, objective symptoms, mental state, and social function. Result After intervention, the scores of spasticity, and physiological, mental, social, and environmental factors were significantly improved in both groups (P<0.01,P<0.05). Compared to rehabilitation, Tiao Ren Tong Du needling plus bloodletting at Jing-well points can more significantly release the muscular spasticity and reduce the PRO score (P<0.01). The recovery plus markedly-effective rate was 70.6% in the treatment group versus 42.4% in the control group. Conclusion Tiao Ren Tong Du needling plus bloodletting at Jing-well points can effectively improve post-stroke spastic state and the quality of life.

Objective To investigate the influence of arsenic trioxide (AS2 O3 )in the vasculogenic mimicry (VM ) of HepG2 cells, and to preliminary clarify the possible mechanism of inhibition of AS2 O3 on the VM. Methods Themean inhibitory concentration (IC50 )of AS2 O3 72 h after treatment of HepG2 cells was calculated by CCK-8 assay.The HepG2 cells were cultured on 3-D Matrigel and randomly divided into control group, 1/2 IC50 AS2 O3 group and IC50 AS2 O3 group.IPP software was used to calculate the number,length and area of VM,and the expression levels of VM-related proteins VE-cadherin and MMP-2, apoptotic-related protein caspase-3 and proliferation-related protein PCNA were detected by Western blotting method.Results The IC50 of AS2 O3 was 10μmol·L-1 72 h after treatment of HepG2 cells.The number,length and area of VM in 1/2 IC50 and IC50 AS2 O3 groups were significantly lower than those in control group (P<0.01);the number,length and area of VM in IC50 AS2 O3 group were also lower than those in 1/2 IC50 AS2 O3 group (P<0.05).Compared with control group,the expression levels of VE-cadherin and MMP-2 in 1/2 IC50 and IC50 AS2 O3 groups were decreased (P<0.05),and the expression levels of caspase-3 and PCNA had no significant change (P>0.05).Conclusion AS2 O3 can inhibit the forming of VM of HepG2 cells,which indicated that its mechanism may be related to inhibiting the expressions of VE-cadherin and MMP-2 .