Objective:To put forward some suggestions for the national health development in the filed of health expenditure indicators .Methods:Two health expenditure indicators and four health outcomes indicators were chosen from WB and WHO official websites , and researches on the relationship between health expenditure and outcomes were conducted .We put forward proposed value of the health cost indicator .Results: With different levels of GDP per capita , the scatter diagram of health expenditure and GDP per capita had different rules .When health outcomes were taken into consideration , the rules were the same .When GDP per capita was at different level , better health outcomes were not related to higher health expenditure .Input-output ratio should be taken into consideration fully . Suggestions:The study should be dynamic as GDP develops .More factors can be added in the research , if the data of the factors is available .In this study , the GDP per capita was divided into 4 sections .The division standard of the GDP per capita can be more delicate .What is more important for the development of health expenditure is not contin-uing input , but better input-output ratio because of diminishing of marginal returns .One set of standards cannot be a-dapted to all countries and districts .We should give full consideration to the improvement of people's health instead of increasing input because the ultimate goal is the former .

Objective To explore the role of microRNA-206 (miR-206)in peripheral blood mononuclear cells (PBMC)from rheumatoid arthritis (RA)patients.Methods 27 patients with RA and 25 healthy controls were enrolled into the current study.Human peripheral blood mononuclear cells (PBMCs)were isolated by standard density-gradient centrifugation over Ficoll-Hypaque solution in rheumatoid arthritis and healthy control volunteers.Total RNAs were extracted from PBMCs which were stimulated by PMA and ionomycin,then the RNA was transcribed reversely into cDNA.The expression of mi-croRNA-206 and Kruppel-like factor 4 (KLF4)and the orphan nuclear receptor RORγt mRNA was detected by real-time quantitative PCR (qRT-PCR)method.Student’s unpaired t-test and spearman correlation were used for statistica1 analysis. Results The expression of miR-206 in the PBMCs of RA patients was significantly decreased compared with that of the healthy controls (0.056±0.019 vs 0.138±0.057,t=3.103,P<0.01),The levels of KLF4 and RORγt mRNAin the PB-MCs of RA patients were increased significantly verves those of the healthy controls(0.604±0.183 vs 0.098±0.027,t=6.651,P<0.01;0.583±0.271 vs 0.069±0.018,t=7.438,P<0.01),Furthermore,a negative correlated between the ex-pression of miR-206 and KLF4 or RORγt mRNA in RA patients (r=-0.639,P<0.01;r=-0.842,P<0.01).Conclusion These results indicated that the augmented expression of KLF4 mRNA may be caused by the attenuated expression of miR-206,and the high level of KLF4 mRNA evokes the proportion of Th17 cells in RA patients.

OBJECTIVE: To investigate brain regional homogeneity (ReHo) changes of multiple sub-frequency bands in cirrhotic patients with or without hepatic encephalopathy using resting-state functional MRI. MATERIALS AND METHODS: This study recruited 46 cirrhotic patients without clinical hepatic encephalopathy (noHE), 38 cirrhotic patients with clinical hepatic encephalopathy (HE), and 37 healthy volunteers. ReHo differences were analyzed in slow-5 (0.010−0.027 Hz), slow-4 (0.027−0.073 Hz), and slow-3 (0.073−0.198 Hz) bands. Routine analysis of (0.010−0.080 Hz) band was used as a benchmark. Associations of abnormal ReHo values in each frequency band with neuropsychological scores and blood ammonia level were analyzed. Pattern classification analyses were conducted to determine whether ReHo differences in each band could differentiate the three groups of subjects (patients with or without hepatic encephalopathy and healthy controls). RESULTS: Compared to routine analysis, more differences between HE and noHE were observed in slow-5 and slow-4 bands (p < 0.005, cluster > 12, overall corrected p < 0.05). Sub-frequency band analysis also showed that ReHo abnormalities were frequency-dependent (overall corrected p < 0.05). In addition, ReHo abnormalities in each sub-band were correlated with blood ammonia level and neuropsychological scores, especially in the left inferior parietal lobe (overall corrected p < 0.05 for all frequency bands). Pattern classification analysis demonstrated that ReHo differences in lower slow-5 and slow-4 bands (both p < 0.05) and higher slow-3 band could differentiate the three groups (p < 0.05). Compared to routine analysis, ReHo features in slow-4 band obtained better classification accuracy (89%). CONCLUSION: Cirrhotic patients showed frequency-dependent changes in ReHo. Sub-frequency band analysis is important for understanding HE and clinical monitoring.
Ammonia ; Benchmarking ; Brain* ; Classification ; Healthy Volunteers ; Hepatic Encephalopathy* ; Humans ; Liver Cirrhosis ; Magnetic Resonance Imaging* ; Parietal Lobe

Cervical lymph node metastasis in thyroid cancer is closely related to the disease recurrence and prognosis of patients. Accurate judgment of lymph node metastasis is vital for tumor stage and treatment in patients with thyroid cancer, which can effectively improve the prognosis of patients. However, preoperative detection of cervical lymph node metastasis is the key points and difficulties in individualized treatment of thyroid cancer. Currently, fine needle aspiration washout fluid thyroglobulin is often used to assess cervical lymph node metastasis of differentiated thyroid cancer preoperatively, and it has a higher diagnostic efficacy. The continuous exploration and application of tumor markers and emerging biomarkers have provided new perspectives for the preoperative diagnosis of lymph node metastasis in thyroid cancer. As a new non-invasive detection technique, liquid biopsy is convenient to obtain samples and has broad clinical application in early diagnosis of cervical lymph node metastasis of thyroid cancer. In addition, the analysis and application of liquid biopsy biomarkers will help the development of clinical diagnosis and treatment strategies, and provide the possibility of early precision therapy for thyroid cancer patients. This review summarizes current research surrounding the molecular markers related to cervical lymph node metastasis of thyroid cancer.

Ferroptosis is a new type of regulatory cell death and is mainly caused by changes in intracellular iron homeostasis due to various inducers,which promotes the occurrence of iron ion-dependent lipid peroxidation,thereby leading to the accumulation of toxic lipid peroxides and finally resulting in cell death.Hepatic ischemia-reperfusion injury is a common and serious complication after liver surgery,with the main mechanisms of anaerobic respiration,mitochondrial injury,oxidative stress response,inflammatory response,calcium overload,and microcirculation dysfunction.This article introduces the concepts and mechanisms of ferroptosis and hepatic ischemia-reperfusion injury and summarizes some related treatment strategies,so as to provide a reference for exploring new treatment methods for hepatic ischemia-reperfusion injury.

Mitochondrial dysfunction is closely related to the occurrence and development of benign and malignant diseases of the pancreas. Mitochondrial membrane of the respiratory chain electron transfer and energy transfer plays an important role in maintaining normal cellular function. When the respiratory chain was disrupted, the oxidative stress was increased in the cell, and produced a large number of oxide intermediate products which target mitochondrial protein, DNA, etc, lead to mitochondrial dysfunction finally induced acute pancreatitis, pancreatic cancer and other diseases. In addition, mitochondrial homeostasis plays an indispensable role in maintaining the normal function of islet cells. This paper reviewed the research status of mitochondrial dysfunction in pancreatic diseases.

Objective To observe the effect of a pulsed electromagnetic field (PEMF) on the bone structure and metabolism of rats with disuse osteoporosis (DOP).Methods One hundred 4-month-old female Sprague-Dawley rats were randomly divided into a control group (INT group),an osteoporosis model group (DOP group),a sodium alendronate group (ALN group) and a pulsed electromagnetic field group (PEMF group),each of 25.The right hind-limbs of the rats in the DOP,ALN and PEMF groups were immobilized by tibia-tail fixation for two weeks to establish a DOP model.The rats in the ALN group were given 1 mg/kg of sodium alendronate once a day,while those in the PEMF group received PEMF at 3.82 mT and 10 Hz with a pulse time of 8 ms for 40 min/d.Five rats in each group were sacrificed at the 2nd,4th,8th and 12th week and their right hind-limbs were separated to measure the bone mineral density (BMD),structural mechanics indexes (the maximum load,maximum displacement and rupture energy) and material mechanics indexes (maximum stress,maximum strain and modulus).Moreover,the expression of tumor necrosis factor alpha (TNF-α) and bone morphogenetic protein 2 (BMP-2) were detected using immunohistochemical methods.Results The average BMD of the model group was significantly lower than that of the ALN group after 2 weeks,and lower than that of the PEMF group after 4 and 8 weeks.After 12 weeks the average BMD of the PEMF group was significantly higher than that of the ALN and model groups.After two and four weeks,all the structural and material mechanics measurements had decreased significantly compared with those of the control group.The average maximum displacement and load of the ALN group had increased significantly compared with the model group after 4 weeks of treatment.After 8 weeks the average maximum load,maximum displacement,rupture energy and maximum stress of the ALN and PEMF groups had increased significantly compared with the model group.Compared with the model group,the average level of TNF-α decreased gradually in both the ALN and PEMF groups from the 2nd week on,while that of BMP-2 increased from the same time point.However,at the 8th week the expression of BMP-2 protein in the PEMF group was on average significantly higher than in the ALN group.Conclusion Both PEMF and sodium alendronate can increase bone density,but PEMF has more persistent effects.

Cholangiocarcinoma is a highly malignant tumor with a poor prognosis, limited treatment options, and complicated pathogenesis. Competitive endogenous RNA is a kind of transcripts that can competitively bind miRNA, including long non-coding RNA and circular RNA. Competitive endogenous RNA is known to be involved in a variety of tumors. It can modulate the occurrence and development of cholangiocarcinoma by regulating the biological behavior, cell metabolism, inflammatory process and epithelial-mesenchymal transition of cholangiocarcinoma cells. Here we review recent research progress on the role of long non-coding RNA and circular RNA in cholangiocarcinoma to help better understand the pathogenesis of cholangiocarcinoma.

Flash radiotherapy is a kind of radiotherapy method using ultra-high dose rate radiation. Compared with the traditional dose rate radiotherapy, it has unique radiobiological advantages. In this paper, the principle of flash radiotherapy, the process and results of biological experiments are summarized. At the same time, the advantages and challenges of flash radiotherapy are analyzed, and the future clinical application is prospected.
Radiotherapy/methods* ; Radiotherapy Dosage ; Technology