Objective To assess the leading causes of death and disability adjusted life year (DALY) due to non-communicable disease (NCD) in China.Methods World Health Report 2004 published by the World Health Organization (WHO) was reviewed,including total deaths,deaths per 100 000,agestandardized death rate per 100 000,total DALYs,DALYs per 100 000 and age-standardized DALYs per 100 000 by cause and by member state.Diseases or injuries were assigned to three levels:communicable diseases,NCD and injuries (the first level); categories of disease or injure (the second level); specific diseases (the third level).R2.15 was used for data analysis.Results NCD causes 737.6 million deaths,141million total DALY years,627 age standardized mortality per 100 000,and 10 829 age-standardized DALYs per 100 000.NCD account for 79.4％ and 70.3％ total death or all-cause DALYs.Conclusions Cardiovascular disease,malignant neoplasm and respiratory disease were the leading causes of death,while neuropsychiatric disorder,cardiovascular disease and sense organ disease were the most important causes of DALYs.Among China,the United Kingdom,the United States,Canada,Japan,Korea and India,China ranked second in age-standardized mortality rate of chronic disease.DALYs of esophagus cancer and chronic obstructive pulmonary disease were 6 or 2 times of world average level.Besides,the increasing trend in the prevalence of diabetes mellitus remains impressive.

Objective:To understand the implementation status of case-based payment among healthcare provid-ers and their cognition on the matter. Methods:Semi-structured interview was conducted on 30 purposely selected staff from 9 hospitals in Chengdu. Results:After one-year implementation of case-based payment, hospitals at different level carried out the policy vigorously:executed corresponding expense control measures and management. Neverthe-less, the proportion of cases that were paid with case-based payment was low, moreover the inclusion criteria for case was of disunity and the formulation of the expense standard was ambiguous to some extent. Conclusion:Certain achievements were accompanied with problems, so it is essential to refine reimbursement standards, improve case-based payment, make clear the inclusion criteria for case and extend the covering range of case-based payment in Chengdu. In addition, the medical insurance agency should strengthen the supervision of healthcare providers,and guide them to set up effective incentive mechanism.

OBJECTIVE:To provide reference for promoting the priority use of essential medicines. METHODS:The use amount ratio of essential medicines in 2 third-level grade-A hospitals in Beijing from 2011 to 2013 was statistically investigated. And the literatures related to policies of essential medicines and application were retrieved for in-depth analysis. RESULTS:The use amount ratios of essential medicines in the outpatient and emergency departments in Beijing Hospital of Ministry of Health from 2011 to 2013 were respectively 24.04%,23.10% and 22.76%;and the use amount ratios of essential medicines of inpatients were respectively 16.56%,14.52% and 12.04%. The use amount ratios of essential medicines in the outpatient and emergency depart-ments in Beijing Friendship Hospital(a pilot hospitals of cancelling drug addition medical reform)in the 3 years were respectively 21.59%,19.85% and 22.93%;the use amount ratios of essential medicines of inpatients were respectively 17.70%,17.62% and 15.89%. The use amount ratios of essential medicines did not meet 25%-30% of the requirements. CONCLUSIONS:Cancelling the drug addition and adjusting the types and quantity of essential medicine list had no obvious effects on the use amount ratios of gen-eral third-level grade-A hospitals. It is suggested to promote the priority use of essential medicines by systems of medical insurance total amount prepayment,single disease payment or diagnosis related groups-based prepayment and the free policy of essential medi-cines,rather than administrative order.

Objective:To investigate the application value of adnephrin in TACE on the apud -advanced liver cancer. Methods:144 patients with apud -advanced liver cancer were randomly divided into two groups,In treatment group of 72 cases,patients were injected small dose of epinephrine prior to the chemotherapy drugs and lipiodol emulsion ; In control group of 72 cases,patients were treated with conventional chemotherapy and embolism,which the chemotherapy drugs and lipiodol ultra liquid were the same basically. Results:The efficiency of the treatment group was 61.1%,36.1% for the control group.The changes of intrahepatic tumor、postoperative liver function and the quality of life had a significant deviation in two groups between pretherapy and post-treatment (P

Objective To investigate the expression of ADAM8 in patients with hepatocellular carcinoma (HCC) and its clinical significance.Methods The protein expression of ADAM8 in HCC tissues was analyzed using immunohistochemical analysis.Serum levels of ADAM8 were measured by ELISA in 126 patients with HCC,50 patients with liver cirrhosis (LC) and 50 healthy individuals.The relationship between patients' pathological features and serum ADAM8 level was analyzed.Results Immunohistochemical analysis showed that ADAM8 expression was associated closely with serum AFP elevation,tumor size,histological differentiation,and tumor stage.The ELISA assay showed that the serum levels of ADAM8 in the HCC were significantly higher than those in LC and healthy groups.Kaplan-Meier survival analysis showed that high expression of serum ADAM8 exhibited a significant correlation with poor prognosis for HCC patients.Multivariate analysis revealed that serum ADAM8 expression is an independent prognostic parameter for the overall survival rate of HCC patients.Conclusion ADAM8 expression was closely associated with tumor size,serum AFP elevation,tumor differentiation,tumor stage and prognosis in hepatocellular carcinoma.Therefore,ADAM8 expression may serve as a biomarker for predicting the prognosis of patients in hepatocellular carcinoma.

Objective To investigate the circadian and seasonal distribution of cardiovascular events (CVE) and the relationship between average monthly temperature and the incidence of CVE. Methods A total of 5837 emergency patients with CVE were enrolled from 1997 to 2007. The exact admission time of each patient was registered. The average monthly temperature data from a regional weather station for this time period was supplied by the meteorological office of the city. The relationship between the average monthly temperature and the incidence of CVE was explored and the corresponding curves were plotted. Results The occurrence of CVE has obvious seasonal variation, and its a higher tendency of episodes was found in spring and winter periods. High incidence of acute myocardial infarction, angina pectoris, acute left-sided heart failure, hypertensive crisis, and sudden death occurred in spring and winter as wee as the time for a change of season, that is, January, February, March, April, October, November, and December. There was a significant negative correlation between the incidence and the average monthly temperature (P<0.005-0.001). Circadian rhythm of CVE was present, with a peak in the early morning and forenoon. Conclusion There are circadian and circannian rhythms of the incidence of CVE. Cold weather condition is a risk factor for the occurrence of CVE, which usually peaks in the early morning and forenoon.

Objective To explore the impact of sulfentanyl on sufentanil epidural block during abdominal panhysterectomy. Methods 90 patients scheduled for panhysterectomy were randomly divided into three groups. Tthe control group received epidural administration of 1% ropivacaine of 0.2 mL/kg after 2% idocaine of 3 mL , while the study group 1 received 10μg sufentanil and the study group 2 received 20μg sufentanil in addition to the medications used in the control group. The anesthetic effect, changes in vital signs, and incidence of adverse reactions were compared among the three groups. Results In group S1 and group S2, the onset of epidural anesthesia was faster , time to the highest plane of sensory blockade and time to degree 3 in the Bromag scores were faster , duration of sensory blockade was longer , and OAA/S score was better , as compared with group D , with significant statistical significances (P<0.01);and the effect was better in group S2 than in group S1. There was no difference among the three groups in adverse reactions. MAP , HR and SPO2 were lower in groups S1 and S2 than in group D during the procedure, with a statistical difference (P<0.05). Conclusions Proper dose of sufentanil plays a positive role in ropivacaine epidural block during panhysterectomy , not only increases the onset of anesthesia, but also makes the anesthestic effect better, and has higher safety It is worth popularizing clinically.

Objective To construct a conceptual framework of a lifestyle questionnaire and define its dimensions,sub-dimensions and core data elements.Methods After review of lifestyle questionnaires of large-scale studies,domestic and international health information standards,health risk factors defined by the World Health Organization and paper-based health records,a conceptual framework was developed by using top-down and bottom-up strategies.Core data elements were chosen according to their importance,utility and experts' advice.Results Our conceptual framework included 9 dimensions (cigarette smoking,alcohol consumption,diet,water drinking,employment,physical exercises,daily living habits,sleep and toxic exposure) and 29 sub-dimensions.For instance,cigarette smoking included status,intensity,duration of smoking and kinds of tobacco.Furthermore,24 core data elements were extracted,and coded values were defined for parts of these data elements.Conclusions Our conceptual framework may serve as a reference for the development of lifestyle questionnaire,and the standardized data elements we extracted could be used in information exchang between institutions.However,standardization of the data elements should be further refined.

Objective To analyze the different expressed protein of pleural effusion caused by tuberculosis and to identify proteins associated with tuberculous pleural effusion for building an economic , rapid, and accurate diagnostic method. Methods Two-dimensional gel electrophoresis technology was applied to separate protein in pleural effusion of 20 cases of tuberculous pleurisy ,19 cases of lung cancer patients and 6 cases of transudate. Analysis of isoelectric point, the range of molecular weight, matching rate and grey value of the protein was carried out by the PDQuest8.0 software.Then the electrophoregram was compared to get the distinct protein. Results There were 13 differential protein spots between tuberculous pleural effusion and the transudateand 9 protein spots were highly expressed for two folds, but 4 protein spots poorly expressed for 0.5 folds in pleural effusion caused by tuberculous pleurisy. There were 11 differential protein spots between tuberculous and malignant pleural effusion and 5 protein spots were highly expressed , but 4 protein spots poorly expressed in pleural effusion caused by tuberculous pleurisy , while 2 protein spots were expressed only in the pleural effusion caused by lung cancer. Conclusion Two-dimensional electrophoresis technology is available to acquire an electrophoretogram of pleural effusion caused by tuberculosis , lung cancer and transudate with well resolution and high repetition rate.In addition, there are different protein spots.

Objective To investigate the applied value of 3.0T blood oxygen level dependent(BOLD) MRI in the diagnosis of hepatic warm ischemia-reperfusion injury (WIRI) in rabbits.Method Twenty healthy adult New Zealand white rabbits were randomly divided into two groups by using the stochastic indicator method.In 10 rabbits enrolled in the treatment group,the model of hepatic WIRI after ischemia for 30 min followed by 6-h reperfusion was established,and the remaining 10 rabbits were chosen as the normal control group and were not subjected to any surgery.All the experimental rabbits were scanned by 3.0T MRI and BOLD MRI.T2* values were separatelymeasured by 2 considered radiologists and the R2* values were calculated (R2* =1/T2*).Thereafter,the intra-class correlation coefficient (ICC) was used to check the consistency.All rabbits were killed after MR examination and routine assays were performed for testing the levels of alanine aminotransferase (ALT),aspartate aminotransferase (AST),and lactate dehydrogenase (LDH) in the ear vein blood serum.The contents of total superoxide dismutase (SOD),malondialdehyde (MDA) and myeloperoxidase (MPO) in liver tissues were determined,and histopathological changes were examined.The correlation between R2 * value and clinical test index was evaluated by Spearman correlation analysis.The R2* value was evaluated by ROC curve.Result ICC =0.87 ＞ 0.75,suggesting that the repeatability of the outcome is good.Compared to the normal control group,R2*value of the warm ischemia-reperfusion injury group was increased (P =0.000).The differences in ALT,AST,LDH,total SOD,MDA and MPO between the two groups were statistically significant (P＜0.01).R2* values were significantly positively correlated with ALT,AST,LDH,MDA and MPO (r＞0.6,P＜0.05),and there was a significantly negative correlation between R2* and total SOD (r=-0.663,P=0.001).The R2* value could efficiently diagnose rabbit hepatic WIRI (AUC =0.99) with the best diagnostic threshold being 116.40 Hz.Conclusion 3.0T BOLD MRI can accurately and non-invasively assess the pathophysiologic changes caused by WIRI.It is of great importance for 3.0T BOLD MRI in dynamically monitoring and evaluating hepatic WIRI.