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.

Objective To apply a non-invasive and feasible method for the quantification of local wall shear stress (WSS) in vivo using magnetic resonance imaging. Methods The fight common carotid artery of a young healthy male volunteer was examined using cine phase-contrast MR sequence. The cross- sectional area, average flow velocity, maximum velocity and flow rate were obtained. Three dimensional paraboloid model was applied to measure WSS value at common carotid artery. Results The mean/peak WSS was (0.75±0.41)N/m2 for the common carotid artery; The mean (range) velocity was (23.4± 12.0) cm/s; The mean (range) luminal vessel area was (32.2±2.9) mm2; The blood flow rate was (7.8±4. 6) ml/s; Conclusion WSS's magnitude, distribution and changes can be determined by MR imaging combining with the three-dimensional paraboloid method.

Objective Based on the analysis of time domain of heart sound with envelop to extract the envelope character of heart sounds.Methods The envelope extraction of heart sounds based on Hilbert-Huang Transform was given.Firstly,the original heart sounds signal was preprocessed by Huang Transform.Secondly,the envelope of heart sounds was got with Hilbert Transform.Results The first heart sound and the second heart sound were extracted,and all kinds of characters in time domain of heart sound were acquired more accurately.Conclusion The envelope of heart sound is extracted correctly.The foundation for further analysis of heart sounds is established.

Liver metastasis is the advanced stage of gastric cancer,which is a leading cause of death.Radiofrequency ablation (RFA) is an alternative method of comprehensive treatment in patients with gastric cancer liver metastasis due to its advantages of safety,minimal invasion and repetition.The efficacy of RFA alone,the efficacy of the combined treatment of RFA with other therapies and prognostic factors of RFA in gastric cancer liver metastasis were reviewed in this article.

Objective To explore the relationship between fatty liver and body mass index (BMI), serum lipid levels in aging population. Method 748 of retired people (≥45 years) were studied. All participants accepted liver B -mode Ultrasonography examination, height, weight and blood lipid detection. The relationship between Fatty Liver and BMI, serum lipid levels were analyzed. Results The detection rate of Fatter Liver in male and female was 61.8% and 44.6% separately. The detection rate of Fatter Liver was 53.4% in the aging group (45~59 years), while the rate was 51.0% in elderly group (≥60 years). Compared to the 23.07 kg / m2 and 1.58 mmol/L in group without fatty liver, the BMI and serum triglyceride was 26.77 kg / m2 and 2.13 mmol / L in the group suffered the Fatter Lever. There existed statistically significant differences of Body Mass Index and serum Triglyceride level between the group with and without fatty liver (P

Objective To investigate the effects of different anesthesia methods on oxidative stress in elderly patients undergoing neurosurgery.Methods Totally 60 patients undergoing neurosurgery were randomly divided into 3 groups:propofol group,isoflurane group and sevoflurane group (n-20 each group),heart rate(HR) and mean artery pressure(MAP) in all patients were recorded at the time points of pre anesthesia (T0),incision of skin (T1),incision of dura (T2),end of operation (T3).The activity of superoxide dismuase (SOD),catalase (CAT),and glutathione peroxidase (GSH-Px) were measured at the time of T0,6 h (T4),24 h (T5),48 h (T6),72 h (T7)after operation.The efficacy of anesthesia was evaluated by Glasgow Outcome Score (GOS) at 3 months after operation.Results The activity of SOD,CAT and GSH Px in 3 groups were lower at T5and T6 than at T0 (P＜0.05).The SOD activity at T4,T5,T5and TTwere higher in propofol group [(87.2±11.8) U/ml,(75.1±12.4) U/ml,(84.6±9.3) U/ml,(92.5±12.5) U/ml,respectively]than in isoflurane group [(75.0±12.2) U/ml,(63.8±8.9) U/ml,(70.3±9.0) U/ml,(82.5±13.5) U/ml,respectively] and in sevoflurane group [(79.4±10.4) U/ml,(68.7±10.5) U/ml,(72.0±10.9) U/ml,(85.17±8.41) U/ml,respectively] (all P＜0.05).The CAT activity at T5 was higher in propofol group [(66.59±7.21) U/ml] than in isaflurane group [(51.58±8.19) U/ml] and in sevoflurane group [(58.49±7.27) U/ml] (both P＜0.05).The GSH-Px activity was higher at T4,T5and T6 in group propofol[(159.2 ± 20.8) U,(140.7 ± 16.2) U,(152.3 ± 19.1) U,respectively] than in isoflurane group [(129.4±17.9) U,(108.3±15.9) U,(118.4±14.1) U,respectively] and in sevoflurane group [(140.1±15.8) U,(125.2± 17.1) U,(137.9±10.7) U,respectively] (all P＜0.05).The outcome of neurosurgery had no significant differences among the 3 groups (P＞0.05).Conclusions Propofol has a better effect on oxidative stress than isoflurane and sevoflurane in elderly patients undergoing neurosurgery.

Teaching of clinical practice is the most important part of education of Tradi-tional Chinese Medicine(TCM).We plan to make clinical rotation internships,standardize the whole process of internships,standardized management of clinical teaching,in order to achieve our objectives of TCM Clinical teaching.We hope to guide the medical students to link theory with clinical practice during clinical rotation internships,set up clinical thinking of intern,and practice the basic skills and operating specifications of intern.

Objective:To investigate the expression and relationship of differentiated embryo-chondrocyte expressed gene1(DEC1) and the signal tranducers and activator of transcription3 (STAT3) in gastric cancer tissues,and the significance of the two genes in gastric carcinogenesis. Methods:Immunohistochemistry method of SP was adopted to discover the expression of DEC1 and STAT3 in 59 gastric cancer tissues,19 normal tissues distant from tumor were regarded as control. Results:The positive expression rate of DEC1 in gastric cancer tissues was 71.2%(42/59),which was significantly higher than that in normal para-cancer tissues(26.3%)(P0.05). STAT3 expression was associated with TNM staging,invasion depth,lymph node involvement and tumor grade (P0.05). Conclusions:DEC1 expression was higher in gastric cancer tissues than that in normal para-cancer tissues distant from tumor,and was correlated with STAT3 in gastric cancer. DEC1 and STAT3 are both transcription factors,therefore the co-activation of DEC1 and STAT3 may play an important role in the carcinogenesis and development of gastric cancer.

Objective:To screen the factors that were conducive to prolonging the effective half-life of 131I, and to provide a basis for selecting more suitable patients for the treatment of hyperthyroidism with lithium carbonate assisted radioactive 131I. Methods:Between July 2017 and March 2019, a total of 61 patients (23 males, 38 females, age: 13-73 (37.7±1.9) years) who received lithium carbonate adjuvant therapy before 131I treatment in the First Affiliated Hospital of Zhengzhou University were collected into this prospective study. Clinical parameters (serum free triiodothyronine (FT 3), serum free thyroxine (FT 4), iodine uptake rate (2 h, 12 h, 24 h) and ratio of iodine uptake rate (2 h/24 h, 4 h/24 h) before and after taking lithium carbonate were compared by using paired t test. The factors which were conducive to prolonging the effective half-life of 131I were analyzed by linear and multiple regression analyses. Results:Compared with the pretreatment results, lithium carbonate treatment significantly improved the 24 h iodine uptake rate ((74.82±2.69)% vs (82.38±2.33)%; t=2.674, P=0.010), decreased the ratio of 4 h/24 h iodine uptake rate ((88.96±2.85)% vs (82.12±2.27)%; t=2.644, P=0.010), prolonged the effective half-life of 131I ((123.03±3.09) vs (130.38±2.49) h; t=2.656, P=0.010), and decreased serum FT 3 ((26.46±1.65) vs (21.31±1.42) pmol/L; t=3.421, P=0.001) and serum FT 4 ((56.59±2.12) vs (49.24±2.19) pmol/L; t=3.289, P=0.002). Linear regression analysis showed that 2 h and 4 h iodine uptake rate, the ratios of 2 h/24 h and 4 h/24 h iodine uptake rate, and effective half-life of 131I before lithium carbonate treatment were related to the effective half-life of 131I after lithium carbonate treatment ( b values: from -0.576 to 0.642, all P<0.05). Multiple linear regression analysis showed that the ratio of 4 h/24 h iodine uptake rate was the main factor affecting the effective half-life of 131I after taking lithium carbonate ( b=0.642, 95% CI: 0.453-0.832, P<0.001). Multiple linear regression equation was y=-49.785+ 0.642 x. Lithium carbonate treatment could prolong the effective half-life of 131I if the ratio of 4 h/24 h iodine uptake exceeded 77.55%. Conclusion:The ratio of 4 h/24 h iodine uptake rate is the main factor affecting the change of the effective half-life of 131I after lithium carbonate treatment, and patients with hyperthyroidism whose ratio of 4 h/24 h iodine uptake rate exceeds 77.55% can effectively prolong the effective half-life of 131I after taking lithium carbonate.