Objective: To predict the growth trend of total health expenditure in China based on the dynamic relationship between total health expenditure and economic growth. Methods: First, analyze the relationship between total health expenditure and economic growth from 1978 to 2011 with the state space model, evaluate the accuracy of the model and predict total health expenditure range from 2012 to 2016 with the status space mode. Results: Up to 2016, the total health expenditure would reach to 5.681 trillion yuan, and the ratio of the expenditure to gross domestic product(GDP) would increase to 5.692%. Conclusion: It is needed to balance the relationship between total health expenditure and economic growth.

Objective: To describe the non-linear relationship between out-of-pocket ( OOP ) payment and economic growth . Methods: Using logistic smooth transition regression model to analyze the impact of government health expenditure on the non-liner relationship between OOP payment and economic growth. Results:The impact of economic growth on OOP health expenditure is divided into 3 stages:from 1978 to 1996, the influence of economic growth on out-of-pocket payment approaches to highly-efficient mechanism operation;from 1997 to 2008 belongs to the transition period, it stays as low-efficient mechanism operation since 2009. Conclusion: To continue deepening the medical and health system reform and reduce the burden of personal health expenditure.

ObjectiveTo investigate the level of caregiver burden of primary caregivers of children with autism,and explore the factors related to caregiver burden.Methods 177 caregivers of children with autism were tested with caregiver burden inventory(CBI) and childhood autism rating scale(CARS).A cross-sectional and multisite study design was used.ResultsThe scores of caregiver burden was ( 57.50 ± 14.91 ),and time-dependence burden and developmental burden were the most serious domains.Caregiver burden was affected by caregiver's age,caregiver's religious beliefs,caregiver's marital status,caregiver employment status and education degree and children's scores of CARS and degree of CARS( -0.151 ≤ r ≤0.282,P＜ 0.05 ).ConclusionThe data suggest that community care workers should pay attention to caregivers of children with autism and give them personalized health education and intervention according to the demographic characteristics of the caregivers and the severity of children disease.

Breast cancer-related lymphedema (BCRL) is one of the common complications after surgery.The pathogenesis of BCRL is unclear,and there is no definitely effective treatment for it.In this article we review the pathogenesis,risk factors and treatment of BCRL,propose the comprehensive strategies for prevention and treatment of BCRL.

Objective To investigate the quality of life (QOL) of the primary caregivers of children with autism and find the influencing factors.Methods 163 caregivers of children with autism were assessed with short form 36 health survey questionnaire(SF-36) in Chinese,and the data were analyzed by correlation.Results The QOL of the caregivers was injured in many fields.The scores of the eight dimensions of SF-36 were listed respectively as:physical functioning (PF) 84.69 ± 16.39,role limitation due to physical health (RP) 28.87 ± 22.85,bodily pain (BP) 64.72 ± 21.85,general health perception (GH) 50.06 ± 21.80,vitality (VT) 42.79 ± 23.42,social functioning (SF) 52.76 ± 25.46,role limitations due to emotional problems (RE) 32.10 ± 22.27,mental health (MH) 46.17 ± 24.43.The QOL of the primary caregiver was closely related to the caregiver's age,educational level,the family economical situation and time of caring (P ＜ 0.01),and also related to the children's age,autism procedure (P＜0.05).There was no relationship betwecn the QOL and the children's gender,time of participating in rehabilitation training,whether the only child or not,type of medical expense,the caregiver's gender,nationality,marital status,religion,relation with the children,and the family residence.Conclusions The QOL of the primary caregivers of children with autism is affected seriously,and should be intervened accordingly.

To clone the full length cDNA of the tumor rejection gene MAGE-1 from hepatocellular carcinoma(HCC) tissues. This MAGE-1 gene and the tumor rejection antigen encoded by it may be useful in subsequent studies aiming at exploring new strategies for the immunotherapy for HCC. Methods: The full length MAGE-1 cDNA was amplified by RT-PCR method using a pair of primers designed according to the encoding sequence of MAGE-1 gene. The PCR products were then digested by restriction endonucleases and inserted into the plasmid PUC19. After primary selection of the recombinants by endonuclease digestion, the sequences of the inserted gene fragments were confirmed by DNA sequence analysis. Results; Using the same pair of primers, we obtained three clones of different MAGE genes, which were a full length MAGE-1 gene, a 750 bp fragment of MAGE-3 gene and a gene highly homologous to MAGE-6 and MAGE-12 but not identical to any reported MAGE genes. Conclusion: These data suggested that some MAGE genes are expressed in heptocellular carcinoma probably including some unknown genes, which might introduce potential new targets for immune attacks.

BACKGROUND:At present, some neurological imaging methods, including MRI, fMRI, 2-(1-(6-[(2-[18F]fluoroethyl)(methyl)amino]-2-naphthyi) ethylidene) malononitrile (18F-FDDNP) positron emission tomography (PET), are helpful but not specific for the diagnosis of Alzheimer disease (AD). 18F-FDG is a special marker of beta-amyloid (Aβ), thus AD can be diagnosed by 18F-FDDNP PET at early period.OBJECTIVE: To evaluate the role of 18F-FDDNP PET in the diagnosis of AD, and establish reliable clinical biological indexes for the diagnosis of AD patients.DESIGN: A controlled analysis.SETTINGS : Department of Geriatric Neurology and Department of Nuclear Medicine, the General Hospital of Chinese PLA. PARTICIPANTS: Patients visiting the General Hospital of Chinese PLA from May 2004 to March 2005 were selected. Informed consents were obtained from all the participants. ① AD group (n =7): (74.88±12.03) years old; Accorded with the criteria related to diagnosis of AD in NINCDS/ADRDA (National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer Disease and Related Disease Association) and revision of Diagnostic and statistical Manual (DSM-Ⅳ, 4th ed.); brain CT or magnetic resonance imaging (MRI) examination displayed that inter-uncus distance of temporal lobes was ≥ 30 mm. ② Vascular dementia group (n =6): (73.83±4.75) years old; Accorded with the diagnostic criteria of NINDS-AIREN (National Institute of Neurological Diseases and Stroke, USA) and DSM-Ⅳ for vascular dementia; Inter-uncus distance of temporal lobes ＜ 30 mm. ③ Control group (n =6): (71.17±3.71) years old; Without rarefaction of white matter; Intelligence examination was normal.METHODS: PET was performed in all the subjects. PET scanner type was SEIMENS ECAT EXACT HR. The tracer selected was 18F-FDDNP which had radiochemical purity higher than 95% and error of radioactivity measurement lower than 10%. The images were collected at 5, 25 and 45 minutes after injection of 18F-FDDNP. Horizontal and coronary tomograms of brain were obtained after reconstruction.MAIN OUTCOME MEASURES: Characteristics of 18F-FDDNP brain PET images.RESULTS: ① In the control group, signs of obvious atrophy of brain were not seen. At about 45 minutes, the radioactivity in cortex and subcortical nucleus groups was essentially cleared and the structures of brain could not be differentiated clearly. ② In the vascular dementia group, brain atrophy and enlargement of ventricular system to various degrees could be seen. The clearance of radioactivity at three time points was similar to that in the control images. ③ In the AD group, the brain was obviously atrophied and the ventricular system was enlarged. The clearance of radioactivity at the three time points was significantly different from the images of other two groups. The radioactivity in cortex and hippocampus was cleared slower. At 45 minutes, the gray matter could still be clearly differentiated from the white matter, but the radioactivity in corpus striatum and thalamus was not higher than that in cortex and much radioactivity retention could be seen in cortex and hippocampus.CONCLUSION: 18F-FDDNP PET brain images can differentiate AD and vascular dementia, and it is an effective imaging index for the diagnosis of AD.

Objective To investigate the effects of Pseudomonas aeruginosa vaccine (PA) on proliferation and invasiveness of the hepatocellular carcinoma cell line MHCC97L with metastatic potential. Methods Proliferation, growth curve, plate efficiency, flow cytometry, transwell invasion assay, cell motility assay, scarification test, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP2) protein activity were evaluated after cells were treated with PA at various concentrations. Results PA can inhibit the proliferation and plate efficiency of MHCC97L cell markedly in a dose-dependent manner. The IC50 of cells treated with PA for 48 h and 72 h was 3.1 ×108/ml and 1.9 × 108/ml, respectively. The doubling time increased and plate efficiency decreased gradually when cells treated with 0.5 × 108/ml, 1 × 108/ml and 2 × 108/ml PA (P＜0.01). PA could induce cell cycle arrest at the G1 phase in a dose-dependent manner by flow cytometric analysis. The average amount of invading cell per field in cell invasion assay and motility assay were 4. 8 ± 1.3 and 8. 8±2.2 when cells treated with 1× 108/ml PA, which was significantly lower than that of control group (8. 6±2. 1 and 15. 6±1.2 ) (P＜0.01) Scarification test showed that the metastatic ability of cells treated with 1 × 108/ml PA significantly lower than that in the control group. Comparison between cells treated with 1 × 108/ml PA and control group, no remarkable difference was found regarding expression of VEGF and MMP2 in supernatant of cell culture. Conclusion PA can inhibit proliferation and plate efficiency of HCC cell line MHCC97L, which is in part mediated by the cell cycle arrest at the G1 phase. PA could inhibit invasiveness of HCC cell line MHCC97L, which is unrelated to the VEGF and MMP2 protein activity.

Objective To assess the analytical performance of three sensitive cardiac troponin Ⅰ assays and compare the clinical application to provide help in choosing the detection method for clinical laboratory. Methods A total of 474 serum samples were collected from apparently healthy subjects and a total of 112 serum samples were collected from patients presenting with symptoms suggestive of acute myocardial infarction. The functional sensitivities of three assays from Abbott, Beckman-Coulter and Ortho were determined ( CV = 10% ). The reference ranges have been established. The analytic performance was compared according to the assessment mode described by Apple. The relationship was compared among the different assays. The preliminary clinical application value for different detection methods has been evaluated and validated with self-established reference ranges. Results The functional sensitivities ( CV = 10% ) of the cTnI assays for Abbott, Beckman-Coulter and Ortho were 0. 030, 0. 04 and 0. 013 μg/L, respectively.The 99th percentiles of cTnI in healthy volunteers were 0. 021, 0. 02 and 0. 026 μg/L respectively. The analytical data of ROC curve showed that the area under curve (AUC) of the cTnI assays for Abbott,Beckman-Coulter and Ortho for diagnosis of AMI was 0. 852,0. 909 and 0. 910,respectively. There was no statistical difference between any two methods(Z1 = 1.18 ,Z2 = 1.21 ,Z3 =0. 026,all P ＞0. 05). There were good consistency between the 99th percentile obtained from our laboratory and suggested by manufacturers (Kappa value were 1. 000, 0. 730 and 0. 893 respectively, all P ＜ 0. 01 ). Conclusions The analytical performance of two cTnl assays is "clinical accepted" ,the other one is accepted according to guideline. All of them could detect cTnI in apparently healthy subjects. There exist differences among three assays, but their diagnostic characteristics for AMI are not significantly different.

Objective To evaluate the roles of positron emission tomography (PET) with N-methyl [11C]2-(4' -methylaminophenyi-6-hydroxybenzathiazole) (11C-PIB) in the early diagnosis of Alzheimer's disease (AD).Methods Six AD patients,7 mild cognitive impairment (MCI) patients and 6 normal controls (NC) were diagnosed and assessed with brain PET with 11C-PIB.The emission images obtained at 5,25 and 45 min after 11C-PIB administration were analysed.Results Using visual analysis to summarize the characteristics of the imagings of each group: comparing to NC,the AD patients show high 11C -PIB up take,and low clearance rate of 11C-PIB at 45 min.The imagings of MCI group show heterogeneous,overlapping with AD and NC group.The statistical analysis shows: in AD group,the standard uptake value (SUV) ratio of parietal lobe,frontal lobe,temporal lobe,occipital lobe and hippocampal at 45 min was 1.91±0.21,2.09±0.41,1.92±0.35,1.66±0.41,1.55±0.28 respectively,and were higher than that of NC group (value being 1.48±0.53,1.57±0.64,1.36±0.53,1.27±0.40,1.17±0.33) with statistical significance,t=8.114,5.620,5.705,3.650 and 2.866,P=0.0001,0.0002,0.0002,0.0045 and 0.0170 respectively.In MCI group,the SUV ratio of parietal lobe,frontal lobe,temporal lobe,occipital lobe and hippocampal at 45 min was 1.48 ± 0.53,1.57 ± 0.64,1.36±0.53,1.27 ± 0.40,1.17±0.33 respectively,and were higher than that of NC group,but there was no statistical significance.Conclusion 11C-PIB PET imaging can differentiate AD patients from normal and anticipate the transformation of MCI patients.