Objective To conduct an empirical analysis of constitutes and changes of type 2 diabetes patients′ hospitalization expenses and find out the differences and influencing factors so as to provide hospitals and related departments with the decision basis of controlling medical costs, arranging medical resources and optimizing systems.Methods Information of type 2 diabetes patients who had been admitted to a certain first-class grade one hospital in Ningxia from 2013 to 2016 were collected and categorized.Hospitalization costs and influencing factors of the patients were comprehensively analyzed through descriptive statistics, variance analysis and regression analysis.Results The medicine and examination costs as the constitutes of hospitalization expenses were too high.Gender, length of stay, age and diabetic complications were main contributory factors of type 2 diabetes patients′ hospitalization expenses.Conclusion The costs of hospitalization of patients with type 2 diabetes are unreasonable and need to optimize.Type 2 diabetes patients′ hospitalization expenses should be effectively controlled and medical resources should be reasonably used through standardizing treatment behavior, shortening length of stay, intensifying publicity and education, enhancing prevention and reinforcing follow-ups, expanding health insurance coverage and upgrading its level.

Objective Surgical treatment of lung cancer needs to follow strict quality control standard for the aims of accuracy of pathological staging and potentially improved prognosis.However,there are short of studies related to surgical quality analysis.Methods One hundred and twelve patients were enlisted with the diagnosis of lung cancer and received surgical intervention in 2007.Surgical quality of these cases were retrospectively analyzed in compliance with three international standards,National Comprehensive Cancer Network (NCCN),American College of Surgeons’ Oncology Group (ACOSOG),and International Association for the Study of Lung Cancer (IASLC).Results No surgical death was reported in this group.According to NCCN,ACOSOG and IASLC standards,qualified operations were 82 cases (80.4％),73 cases (71.6％),45 cases (44.1％) in 102 cases with R0 resection,respectively.The median total lymph nodes,median mediastinal nodes,and N1 nodes were 27 (range 0-63),16.5 (range 0-43),and 10.5 (range 0-26),respectively.The median mediastinal node stations resected were 4 (range 0-6).In the mediastinum,stations of 4R,5,6 and 7 presented the highest frequency of receiving lymph node dissection.For N1 stations,10 and 12 were among the top list.For the whole group,1-year survival,3-year survival and 4-year survival were 92％ (95％ CI,89-95),67％ (95％ CI,62-72),57％ (95％ CI,52-62),respectively.Conclusion Quality control is the essential part of surgical treatment of lung cancer,which will facilitate the baseline standardization of clinical research.Since IASLC provides the strictest standard for lung cancer surgery,we suggest that all thoracic surgeons need to follow this standard to secure the accuracy of pathological diagnosis and for a potential better prognosis.

ObjectiveTo assess rat behavior, observe apoptotic morphology of neurons and measure expression of caspase-3 in substantia nigra(SN) of Parkinson's disease(PD) animal model. Methods6-OHDA was stereotacticly injected into the right striatum of the rats at two sites to produce PD models. After 5 weeks, the behavior tests including modified Morris Water Maze and narrow beam test were measured. Then tyrosine hydroxylase (TH) histochemistry, Hoechst 33258 staining, Western blotting for caspase-3 in right substantia nigra was separately conducted.ResultsEscape velocity significantly decreased and its latency was obviously enlarged in modified Morris Water Maze, and the latency and total time in narrow beam test were also markedly increased (P<0-05) in 15 successful PD rats compared with either the sham group or the normal group. Furthermore, there were obvious less TH-positive neurons in lesioned SN while more apoptotic cells appeared there. In addition, the expression of caspase-3 was highly upregulated in lesioned SN.Conclusion6-OHDA induced neuronal apoptosis in SN is associated with high levels of caspase-3, and the results of rat behavior tests are correspondent with the morphological changes including TH immunohistochemistry and Hoechst 33258 staining. Thus modified Morris Water Maze and narrow beam test are beneficial for assessments of effects of new drugs in PD animal model.

Objective To evaluate the effect of sevoflurane anesthesia on activation of gliocytes in aged rat hippocampi.Methods One hundred and four male Wistar rats,weighing 600-650 g,were randomly divided into 2 groups (n =52 each) using a random number table:control group (group C) and sevoflurane group (group S).Group S inhaled 3.6％ sevoflurane for 2 h,and open reduction and internal fixation was performed after tibial fracture was induced.Y-maze test and fear conditioning test were carried out on days 1,3 and 7 after surgery.Six rats of each group were chosen on days 1,3 and 7 after surgery and hippocampi were removed to detect the activation of microglias and astrocytes (by immunofluorescence) and expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) (by Western blot).Results Compared with group C,the number of entries into each arm was significantly reduced,the duration of N arm stay was shortened,the percentage of time spent freezing induced by condition and the percentage of time spent freezing induced by context were decreased,and the activation of microglias and astrocytes was increased,and the expression of IL-6 and TNF-α was up-regulated in S groups (P ＜ 0.05).Conclusion Sevoflurane-induced postoperative cognitive dysfunction may be related to enhanced activation of gliocytes in aged rat hippocampi.

OBJECTIVETo provide a theoretical basis for designing of lumbar intervertebral disc prosthesis by collecting the data of the lumbar endplate morphology.

METHODSA total of 100 healthy adults were measured about the following parameters: lumbar lordosis, the Cobb angle of each segment, the concavity depth (ECD) of the endplate, the location of concavity apex (ECA) of the endplate. And a correlation analysis on lumbar lordosis and ECD, ECA was made, respectively.

RESULTSIn total, 100 volunteers were measured. The mean age of the volunteer was 40 years (range 20 - 50 years); the average depth of ECD was (2. 37 ± 1. 42) mm, the average location of ECA was (52. 21 ± 9. 70) %; the average depth of ECD of inferior endplate (IEP) was (2. 81 ± 1. 52) mm (0. 54 - 7. 60 mm), and the parameter of the superior endplate (SEP) was (1. 94 ± 1. 16)mm(0. 39 - 6. 10 mm). The average depth of ECD of the IEP was bigger than of the SEP for each lumbar vertebral body. Most of the location of ECA was at the back of the intervertebral body, the average location of ECA of IEP was (49. 60 ± 8. 78) % (22. 57% - 75. 58%), and the parameter of the SEP was (55. 03 ± 9. 90) % (16. 03% -75. 58%); the mean angle of lumbar lordosis was 39. 760 11. 25°(13. 8° - 72. 00°). There was no obvious correlation between the lumbar lordosis and the ECD (r -0. 193, P =0. 195), neither was the location of ECA(r =0. 080, P =0. 592).

CONCLUSIONMost of the location of ECA is at the back of the intervertebral body, the average depth of ECD is 2. 37 mm, the average location of ECA is 52. 21%.

Adult ; Humans ; Intervertebral Disc ; Lumbar Vertebrae ; anatomy & histology ; Lumbosacral Region ; anatomy & histology ; Middle Aged ; Prostheses and Implants ; Reference Standards ; Spine ; anatomy & histology ; Young Adult

Objective To identify the long-term survival of patients with hepatic carcinoma who received hepatitis B surface antigen (HBsAg) positive donor livers.Method A total of 195 patients were enrolled in the study.They were all diagnosed as having hepatic carcinoma with malignant thrombus in portal vein pre-operation and received liver transplantations between 1999 and 2014.The long-term survival between the patients who received HBsAg positive grafts and those who received HBsAg negative grafts was compared.Result There were no differences in ages,preoperative tumor stages and postoperative mortality between the two groups.There was significant difference in survival time between the two groups (Z=-2.038,P =0.042),with the median survival time of 8.83 months (2.50-24.80 months) in HBsAg positive graft group and 13.12 months (6.50-27.65 months) in HBsAg negative graft group,respectively.The long-term survival rate in HBsAg positive graft group was 48％ and that in HBsAg negative graft group was 34.7％ (P =0.740,x2 =0.110).However,the proportion of deaths due to recurrence of tumor was high to 75.8％ in all causes.Conclusion To prolong the survival time,it is safe and feasible to receive HBsAg positive donor livers in patients with hepatic carcinoma in late stage.However,tumor recurrence was still the main causes of deaths in patients post-operation because of the advanced tumor conditions pre-operation.

Objective To explore the normal range of cingulate cortex volumes of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers ( age range = 18 to 70) recruited from 15 hospitals were divided into 5 groups, i.e.,Group A (age range = 18 to 30), B (age range=31 to 40), C (age range =41 to 50), D (age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.Cingulate cortex volume (including bulk volume and the left/right volume) was measured semi-manually using 3D volume analysis software.Cingulate cortex volumes among age groups were compared by one-way ANOVA.Right and left cingnlate cortex volumes between sexualities were analyzed by paired samples t test.The relationship between cingulate cortex volume and age was analyzed by Pearson correlations and regression analysis.Results Cingulate cortex volumes of male and female were (20 347 ± 2504) and ( 19 432 ± 2184) mm3 respectively, and the male's was significantly larger than that of female's (two sample t'-test for independent samples, t'= 6.156, P < 0.05 ).Right and left cingnlate cortex volumes of male were ( 10 717 ± 1629) and (9630 ± 1498) mm3 respectively, and those of female's were ( 10 064 ± 1407 ) and ( 9368 ± 1441 )mm3 respectively.The volumes of cingulate cortex were significantly different between right and left in male or female ( t = - 12.960, - 8.511, P < 0.05 ),and right was larger than left.Bilateral cingulate cortex volume in male among group A, B, C, D and E[left: ( 10 132 ± 1291 ), ( 10 113 ± 1638), (9599 ± 1576), (9594 ± 1288), (8710 ± 1212) mm3 ; right:(11 212±1442), (11 096±1602), (11 040±1403), (10 633±1638), (9604±1522) mm3] had statistical differences (F = 16.738, 18.707, P < 0.01 ) ; and those in female among five age groups[left:(9689 ± 1426), (9652 ± 1676), (9347 ± 1500), (9098 ± 1225), (9053 ± 1233) mm3 ; fight: ( 10 558 ±1325), ( 10 266 ± 1463), ( 10 100 ± 1497), (9779 ± 1304), (9617 ± 1254) mm3] also had significant differences (F = 16.859,7.528,P <0.01 ).Bilateral cingnlate cortex volume in both male and female were negatively correlated with age ( r = - 0.330, - 0.324, - 0.169, - 0.243, P < 0.05 ), though the correlation coefficient is not high.Conclusions Cingnlate cortex volume could be accurately measured on the high-resolution MRI with 3D volume analysis software, which can provide morphological data for the construction of database for Chinese Standard Brain.The results may provide normal range for the diagnosis of the volumetric deficits of cingulate cortex.

Background and purpose: Sorafenib hepatocellular carcinoma assessment randomized protocol (SHARP) and sorafenib in patients in Asia-Pacific region with hepatocellular carcinoma (ORIENTAL) had indicated that multi-kinase inhibitor sorafenib could prolong overall survival (OS) and time to progression (TTP) as well as improve progress free survival (PFS) in patients with advanced stage hepatocellular carcinoma. Drug-related adverse events in the course of treatment restricted its clinical application to a certain degree. This study was aimed to summerize the adverse events as well as the management of sorafenib in our clinic. Methods: Twenty-five cases clinically diagnosed as advanced hepatocellular carcinoma were enrolled from January 2008 to October 2009. All the patients who received sorafenib treatment met inclusion criteria as followed: (1) Progression of disease after trans-hepatic arterial chemoembolization therapy; (2) Extensive portal vein cancerous thrombus formation; (3) Portal zone or retroperitoneal lymph node metastasis or multiple remote metastasis, such as lung or bone; (4) Diffused poor blood supply to tumor; (5) Inform consent was obtained. All adverse events with different grade were observed during the beginning 12 weeks, and clinical treatment were carried out relatively. Results: Total of 25 cases were enrolled. Nine patients died of the disease, 3 of them died during the first 12 weeks, 3 patients abandoned sorafenib treatment, among them 2 died before the finish of 12 weeks treatment and 1 patient discontinued 5 months after the sorafenib treatment. Twenty cases finally assigned. Number of patients encountered drug-related adverse events were: HFSR (hand-foot-skin-reaction) 4(4/20), diarrhea 4(4/20), alopecia 5(5/20), rasb 4(4/20), fatigue 8(8/20), leukopenia and Thrombocytopenia 4(4/20), elevated blood pressure 1(1/20) and abdominal pain 1(1/20). After clinical management, 20 patients' sorafenib treatment were eventually not affected by adverse events. Conclusion: Sorafenib was well-tolerated and is a safe option of treatment for patients with advanced hepatocellular carcinoma.

Objective To analyze the incidence and risk factors of de novo hepatitis B virus (HBV) infection from anti-HBc-positive donors in pediatric living donor liver transplantation and to explore the diagnosis and treatment.Method A retrospective analysis was conducted on 105 cases of pediatric living donor liver transplantaions (LT) perfomed during September 2006 to December 2013.HBV markers,including hepatitis B surface antigen (HBsAg) and antibody (anti-HBs),anti-HBc,hepatitis B e antigen (HBeAg) and antibody (anti-HBe) were determined in both donors and recipients before LT and in recipients after LT.HBV DNA titer was measured if the recipients were strongly suspected of de novo HBV infection.Result After 4 perioperative deaths were excluded,101 cases were studied.The median follow-up period of all the patients was 20.5 months (2.7-97.7 months).de novo HBV infection occurred in 6 of 101 recipients (5.9％) 3.5 18 months after LT.Forty-four (43.6％) of the children received HBcAb-positive allografts,and 11.4％ (5/44) of the children were had de novo hepatitis B infection.All five of the HBV-infected children received HBcAb-positive allografts without preventive treatment in 11 cases (5/11,45.5 ％),57 (56.4％) of the children received HBcAb-negtive allografts,and 1.7％ (1/57) of the children had de novo hepatitis B infection.Conclusion Anti-HBc-positive donors can significantly increase the incidence of de novo HBV infection in HBsAg-negative recipients without preventive treatment.with the appropriate treatment strategy,HBcAb allografts can safely used in pediatric recipients.

Objective To observe the effects of hydrogen sulfide (H2S) on structure and function of mitochondria of lung in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Forty healthy male Sprague-Dawley (SD) rats were randomly divided into control group, LPS injury group, and low-, middle-, and high-dose NaHS groups, with 8 rats in each group. The rats in LPS injury group were given LPS 5 mg/kg via sublingual vein, and those in low-, middle-, and high-dose NaHS groups were challenged by LPS for 3 hours followed by intraperitoneally injection of 0.78, 1.56 and 3.12 mg/kg NaHS respectively in a volume of 2 mL/kg. The rats in control group were given 2 mL/kg normal saline via sublingual vein. The rats were sacrificed at 6 hours after model reproduction, and the lung tissues were harvested on time. The mitochondria in lung tissues were isolated with differential centrifugation. The lung mitochondria ultra structures were observed with electron microscope. The content ofmalondialdehyde (MDA) in mitochondria was determined with thiobarbituric acid method, and the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and adenosine triphosphatase (ATPase) were determined with xanthine oxidase method. The mitochondrial activity and swelling were determined by multiskan spectrum.Results It was shown by transmission electron microscope that the mitochondrial structure in the control group was normal. The mitochondria in rat lung cells was swollen with disrupted or disintegrated cristae, the osmiophilic lamellar bodies had fused or disappeared, and rough endoplasmic reticulum degranulation phenomenon was obvious in LPS injury group. The mitochondrial damage was slightly mitigated in the low-dose NaHS group, and it was significantly mitigated in the middle-dose and high-dose NaHS groups. Compared with control group, the MDA content in lung mitochondria in LPS injury group was significantly increased (nmol/mg: 26.30±1.45 vs. 11.16±1.20), andSOD, GSH-Px, and ATPase activities were significantly decreased [SOD (U/mg): 18.78±1.13 vs. 27.44±1.97, GSH-Px (U/mg): 63.91±1.99 vs. 128.15±3.47, ATPase (U/mg): 4.83±0.25 vs. 9.92±0.65]; as well as the activity of the mitochondria was significantly decreased (A value: 0.164±0.025 vs. 0.319±0.045), and the swelling of the mitochondria was significantly increased (A value: 0.182±0.012 vs. 0.273±0.023), all with significantly statistical differences (allP < 0.01). Compared with LPS injury group, the MDA contents in low-, middle-, and high-dose NaHS groups were significantly decreased (nmol/mg: 21.89±1.23, 17.63±1.56, 12.19±1.30 vs. 26.30±1.45), and the SOD, GSH-PX, and ATPase activities were significantly increased [SOD (U/mg): 20.13±0.85, 21.38±1.22, 24.05±1.56 vs. 18.78±1.13; GSH-Px (U/mg): 82.06±1.65, 101.45±2.14, 117.80±2.12 vs. 63.91±1.99; ATPase (U/mg): 5.34±0.23, 7.06±0.37, 8.78±0.44 vs. 4.83±0.25]; as well as the activity of the mitochondria was markedly increased (A value: 0.194±0.018, 0.230±0.032, 0.297±0.038 vs. 0.164±0.025), and the swelling of mitochondria was markedly decreased (A value: 0.195±0.008, 0.219±0.017, 0.249±0.018 vs. 0.182±0.012), all with significantly statistical differences (allP < 0.05). Moreover, the protective effect of NaHS showed a dose-dependent manner.Conclusion It could be concluded that LPS induce mitochondrial structural damage and functional impairment in rats with ALI induced by LPS, and H2S have a beneficial effect against ALI induced by LPS with decreasing the mitochondrial lipid peroxidation level and protecting the cell structure and function, and the effect is correlated with the dosage.