Objective To study the feasibility of laparoscopic total mesorectal excision(TME) for low rectal cancer.Methods Laparoscopic total mesorectal excision was performed in 126 patients with low rectal cancer according to TME principle.Results The operation time was 95 - 180 min,with an average time of ( 117 ± 21 ) min,the amount of bleeding 50 - 200 ml,with an average amount of (90 ± 27 ) ml.2 - 3 days after surgery,gastrointestinal function was restored.Hospital stay was 6 - 14 days,with an average of (8 ± 2)days.Four cases converted to open surgery,the conversion rate for laparotomy was 3.2％.The proportion of sphincter-preserving operation was 95.24％ (120/126).No instant or delayed injury of ureters,large bleeding in front of sacrum and other operation-related severe complications happened intra-and after operation.Conclusion Laparoscopic surgery for low rectal cancer is safe and feasible.

Broad bean has been extensively cultured in China. Its protein content is found 23.59% and has been as a high protein foodstuff. However its ami-no acid pattern is unbalanced, deficient in s-containing amino acid and tr-yptophan. The nutritional value of broad bean protein studied by rat feeding expeirment have indicated that the protein efficacy ratio (PER) is 0.82-1.19; the net protein ratio (NPR) is 2.52-2.48; the biological value (BV) is 47.88-49.54%; the net protein utilization(NPU) is 45.5-46.1% and the true digestion (TD) is 91.7-95.9%. Except for the TD value, all the 4 indicators of broad bean powder have been shown significantly lower than that of casein (p≤0.05), because of the protein of broad bean deficient in s-containins amino acids and tryptophan. It is suggested that broad bean should be ingested together with other food in order to improve the amino acid component for enhancing its nutritional value.

Objective: To analyze the effects of the catastrophic disease insurance of New Rural Cooperative Med-ical Scheme ( NRCMS) on alleviating the economic burden of patients in Beijing, and evaluate the effect of the policy implementation. Methods: Based on high, middle and low economic development levels and the implementation pro-ceedings of catastrophic disease insurance of NRCMS, this paper selects 3 districts of Beijing, from which it chooses two or three villages and towns with the highest numbers of catastrophic disease patients, in order to understand the opera-tional status quo of the catastrophic disease insurance through in-depth interviews with managers. This paper conducts questionnaire survey among all catastrophic disease patients from the sampled villages and towns, and uses 497 valid questionnaires received to understand patients' subjective feelings and collect relevant data of family income and medical expenditure of catastrophic disease patients in 2013. Then it carries out data docking with the platform of NRCMS man-agement centers and measure the economic burden of catastrophic disease patients. In this paper, quantitative and qualitative data are analyzed using statistical and thematic analyses, respectively. Results: The catastrophic disease in-surance of NRCMS has significantly played an important role in reducing the average medical expenditure of catastroph-ic disease patients and improving the actual compensation ratio in varying degrees. However, the incidence of cata-strophic health expenditures has not significantly improved. Conclusion: This paper suggests to increase deductibles and reimbursement ratios of catastrophic disease insurance in order to broaden reimbursement directory and other initiatives to improve the compensation level and focus on alleviating the economic burden of catastrophic disease patients.

Objective:To understand the patients'satisfaction on catastrophic medical insurance of New Rural Cooperative Medical Scheme ( NRCMS ) , and provide references for effective management and policy improvement. Methods:According to the principles of representative sampling, a questionnaire survey conducted. 484 patients got compensation for catastrophic insurance in 2013 were surveyed, and information of medical costs was analyzed. Re-sults:The average medical cost accounts for 84. 57% of total household expenditure. Mandatory medical expenditure is still high and economic burden of diseases is heavy. This policy has increased the compensation rate, and the actu-al compensation rate increases 4. 79% in three districts. The average score of patients' attitude toward catastrophic medical insurance is (3.95±1.05) points, 88. 43% of patients continue to participate in medical insurance. Con-clusions and suggestions:Patients' satisfaction on catastrophic medical insurance of NRCMS is high. It is suggested that the existing financing modes should maintain stability in the short term, and the compensatory rate should be im-proved reasonably.

OBJECTIVETo investigate the effect of Qianlie Huichun on the expression of vascular endothelial growth factor(VEGF) in prostate tissues and expound its anti-prostatomegaly action in model rats with prostatic hypertrophy induced by injected testosterone.

METHODSA total of 60 male rats were eventy randomized into six groups. All were gelded except the normal control group. After a week, the gelded rats were injected with testosterone(4 mg/kg/d), meanwhile the first group were fed with a small dosage of Qianlie Huichun(0.4 g/kg/d), the second group with a medium dosage(0.8 g/kg/d), the third group with a large dosage(1.6 g/kg/d), and the fourth group injected with estriol(2.5 mg/kg/d), all for a month. The fifth group were model controls, and the sixth the normal controls, both fed with the same amount of pure water for a month. Then all the six groups of rats were killed and their prostate glands were resected for the examination of the expression rate of VEGF by immunohistochemical method.

RESULTSThe difference of VEGF expression between Qianlie Huichun groups and the model group was significant(P < 0.01), and so was it between the medium and large dosage middle, large amount of Qianlie Huichun groups and the estriol group(P < 0.01).

CONCLUSIONQianlie Huichun depressed the VEGF expression of the prostate gland in model rats, and the expression rate decreased with the increased amount of the drug, which shows that Qianlie Huichun has a definite therapeutic effect on prostatic hypertrophy by depressed the vascular growth of the vessel in the prostate gland.

Animals ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; Male ; Prostate ; chemistry ; drug effects ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; analysis

BACKGROUND: This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings. METHODS: We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022. RESULTS: Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs . 3.40 ± 1.59 mmol/L in triglyceride ( P  = 0.014), 4.82 ± 0.74 mmol/L vs . 4.88 ± 0.72 mmol/L in total cholesterol ( P  = 0.038), 3.09 ± 0.70 mmol/L vs . 3.18 ± 0.66 mmol/L in low-density lipoprotein ( P  <0.001), and 0.99 ± 0.11 mmol/L vs . 0.95 ± 0.10 mmol/L in high-density lipoprotein ( P  <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition ( P  <0.001). CONCLUSION The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
Humans ; Antiretroviral Therapy, Highly Active/adverse effects* ; Anti-HIV Agents/adverse effects* ; HIV Infections/drug therapy* ; Tenofovir/therapeutic use* ; Retrospective Studies ; Emtricitabine/pharmacology* ; Adenine/therapeutic use* ; Lipids