Objective To learn the present acceptance of patients from outside Tianjin by local hospitals, for improving the management of their medical services.Methods A study of the hospitals′ network system identified 5 306 inpatients from other places in 2016 as evidenced by their hospital settlement account, with analysis of the patient flow from other places by the hospitals surveyed.Medical workers of eight medical institutions which signed the online settlement contract for non-local patients were subject to questionnaire survey.Results Of the 876 respondents,the number of patients willing to receive non-local insured patients accounted for 78.08%.Non-local patients aged 60 or above accounted for 82.31% among the total non-local patients, of whom 48.55% selected hospitals with national key disciplines, and 30.53% chose those with municipal key disciplines.Conclusions An analysis is required for the demand of non-local patients in terms of the social background and population characteristics.Based on such, non-local patient population needs a better management while those with irrational needs should be discouraged with rules and regulations.

Objective: To explore how social support in students of normal college related to their interpersonal attribution and philosophies of human nature, and whether social support varied with different subgroups. Method: Social Support Rating Scale, the Multidimentional-Multiattributional Causality Scale and Revised Philosophies of Human Nature Scale were used in 414 students of a normal university. Result: The social support of students differed significantly among different departments, students of science had lower social support than students of art or sport had. There was no significant difference of social support between sexes, different grades, of urban or rural area. Social support was significantly correlated with "effort" attribution of interpersonal relationship, but not with "ability, background or luck". Social support was positively related to trustworthiness, while negatively to cynicism. Conclusion: This result fits for the common sense of Chinese and people elsewhere.

BACKGROUND: Subsequent to liver transplantation, pulmonary infection and new drug resistant strain frequently appear due to complex pathophysiological changes and abuse of antibiotics.OBJECTIVE: To collect the clinical data of 6 cases who underwent liver transplantation, and analyze the prevention and treatment measures of pulmonary infection after liver transplantation.DESIGN, TIME AND SETTING: Retrospective case analysis, performed in the Department of Hepatobiliary Surgery,First People's Hospital of Guangzhou between January and December 2004.PARTICIPANTS: Six cases that underwent liver transplantation and received treatment in the First People's Hospital of Guangzhou were recruited in the present study. All 6 cases underwent selective homologous whole liver transplantation, 5cases underwent modified orthotopic piggyback liver transplantation, and only 1 underwent classical orthotopic liver transplantation.METHODS: The clinical data of the 6 cases were retrospectively analyzed. After transplantation, basic disinfection,isolation, infection-protection measures should be taken. In addition, etiological information was collected. Chest X-ray was underwent to know the lung at the early stage. Aseptic manipulating was strictly performed during sputum aspiration.Gastrointestinal decompression and non-obstructed drainage were maintained to prevent aspiration. Moreover, preventive anti-infective treatment against the bacteria, fungi, and viruses was performed.MAIN OUTCOME MEASURES: Pulmonary infection and curative effects subsequent to liver transplantation.RESULTS: Of the 6 cases, 5 presented with pulmonary infection, including 1 at 4-11 days after transplantation and 1 at 1day after transplantation. One case died of respiratory failure. The remaining 5 cases were cured after standardized anti-infection, respiratory therapy, sputum aspiration, and nutritional support.CONCLUSION: Application of effective antibiotics, aseptic operation in sputum aspiration, and unobstructed respiratory tract drainage are important measures for treating pulmonary infection subsequent to liver transplantation.

Objective To systematically evaluate the role of laparoscopic living donor hepatectomy in living donor liver transplantation (LDLT).Methods A systematic literature search was conducted on Medline-Pubmed,Embase,Cochrane Library to find studies on laparoscopic living donor hepatectomy for LDLT.All extracted data were analyzed using the RevMan 5 software.Results Ten studies with a total of 1 059 participants were included in this analysis.Laparoscopic donor hepatecomy (LDH) was associated with significantly less intraoperative blood loss [SMD =-0.39,95％ CI (-0.73,-0.05),P ＜ 0.05],lower peak level of postoperative total bilirubin [SMD =-0.24,95％ CI (-0.47,-0.01),P ＜ 0.05]and longer operative time [SMD =0.50,95％ CI (0.04,0.96),P ＜0.05] when compared with those operated with open surgery.On subgroup analyses,hospitalization stay decreased in patients who underwent LDLT with grafts obtained by complete living donor hepatectomy (LDH) and left lateral sectionectomy (both P ＜ 0.05).LDH was comparable to open surgery in donor complication rates and in-hospital cost (P ＞ 0.05).There were no differences on the harvested liver graft size,ischemic time,recipient postoperative liver function and complications between the two groups (P ＞ 0.05).Conclusions Laparoscopic hepatectomy in living donor is a safe procedure for graft-harvesting,which improved the clinical outcomes of the donor,liver graft and recipient in LDLT.It has also the advantages of reduced blood loss,low peak levels of postoperative total bilirubin and short hospitalization stay.

BACKGROUND:Stromal cellderived factor 1 in chemotactic migration of endogenous neural stem cells plays a very important role, but the specific migration mechanism is unclear
OBJECTIVE:To observe the effects of exogenous stromal cellderived factor 1 on chemotactic migration and proliferation of neural stem cells in the rat hippocampus
METHODS:Exogenous stromal cellderived factor 1 (5μL, 500μ/L) was injected into the hippocampus of Sprague-Dawley rats to establish animal models. Brain tissues were taken after days 3, 7, 14 and 21 of perfusion to prepare paraffin sections. Thereafter, nestin expression in the injection region and hippocampus was detected using immunohistochemical method. Experimental control and blank control groups were set.
RESULTS AND CONCLUSION:Paraffin section immunohistochemical results displayed the number of nestin-positive cells in the injection and the hippocampus was gradual y increased. At 3 and 7 days, nestin expression was a little and increased at 14 days, forming a migration tendency to the injection region. At 21 days, there were more nestin-positive cells in the injection area and hippocampus. However, there were no changes as above in the experimental control and blank control groups. The results showed that exogenous stromal cellderived factor 1 may induce the proliferation of neural stem cells in the hippocampus and may be involved in chemotactic migration of endogenous neural stem cells.

Objective To observe the change of serum leptin in different risk stratifications of coronary heart disease (CHD) and to investigate its relationship with the severity of coronary artery lesion and the coronary artery Gensini score and its value in the coronary heart disease risk stratification .Methods According to coronary angiography ,120 research subjects were enrolled and di-vided into 4 groups :the non-CHD group ,stable angina(SAP) group ,unstable angina pectoris(UAP) group and myocardial infarc-tion group(AMI) ,respectively .The serum leptin levels in 4 groups were determined by immunoassay and the correlation between the leptin level with the coronary heart disease risk factor and biochemical markers of risk assessment was analyzed .Results The serum leptin level in the AMI group was significantly higher than that in the non-CHD group and the SAP group ,the leptin level showed the increasing trend with the increase of the coronary lesion severity and the Gensini scores and was positively related with the CHD risk stratification indicators cTnT and smoking index ,and negatively related with blood uric acid .Conclusion The serum leptin may be used as the valuable marker for evaluating the occurrence of acute coronary event and has good correlation with usual biochemical markers of CHD risk stratification and the severity of coronary artery lesion .

This study was conducted to assess the cell proliferation and cell cycle of the directed inducing cartilage cells from rat bone mesenchymal stem cells on collagen sponge and compare the results with those of the plane inducing cartilage cells. The MSCs were isolated from rat bone marrow by density gradient centrifuge and adhesive property, and then were induced into chondrogenic differentiation by adding transforming growth factor-beta1 (TGF-beta1), dexamethasone, transferring and insulin on collage sponge and plane condition. Immunohistochemistry was applied to detect the expression of collagen type II on the scaffolds and plane conditions. The cell proliferation and cell cycle on different conditions were detected with MTT automated colormetric microassay and flow cytometry. The differentiation of MSCs toward chondrogenic phenotype was verified by the positive result of collagen type II on the scaffolds and plane condition. The cell viability in scaffolds was better than that in plane conditions. The S phase and G2 phase were 30 percent in whole cell cycle on the scaffold, which was different from that of the control groups. The method of using the Using directed inducing cartilage from bone MSCs combined with collage sponge to construct tissue-engineered cartilage is feasible; it is better than the method of plane directed inducing.
Animals ; Bone Marrow Cells ; cytology ; Cell Differentiation ; drug effects ; Cells, Cultured ; Chondrocytes ; cytology ; Collagen ; pharmacology ; Mesenchymal Stromal Cells ; cytology ; Rats ; Rats, Sprague-Dawley ; Tissue Engineering ; methods ; Tissue Scaffolds

Objective To analyze the hospitalization costs of new rural cooperative medical system (NCMS)-covered inpatients received by tertiary hospitals in Tianjin with their expenses reimbursed in other localities,for reference of policy making by government departments.Methods NCMS-covered patients who were admitted by 23 tertiary hospitals from May to October in 2017 were followed up and analyzed using their online reimbursement data.Patient expenses were compared among groups of different sources and diseases, using one-way variance analysis and LSD-t for multiple comparison.Results The online reimbursement data of 118 NCMS-covered patients from eight provinces including Liaoning province were collected.The total cost per person averaged 26 744.92 yuan,with 8 890.68 yuan reimbursed,accounting for 33.24%of the expenses incurred.Conclusions The higher proportion of the out-of-pocket payment by patients'results from such factors as higher ratio of non-covered drugs,the lower compensation rate by other provinces on expenses at tertiary hospitals,the medical charges outside the catalog and the medical materials at own expense.Therefore, the compensation policy and medical insurance payment policy should be improved to ensure that the NCMS patients enjoy more reasonable policy treatment.

Objective:To investigate the effect of long-term chronic ethanol consumption on the spontaneous discharge activity of Purkinje cells in the cerebellar cortex of mice.Methods:Fifty 3-week-old ICR mice, regardless of gender, were divided into control group and ethanol group according to the random number table method, with 25 mice in each group. The mice in ethanol group were administered 20% ethanol (1.6 g/kg, once a day) by gavage, and the control group mice were given the same volume of 0.9% sodium chloride solution by gavage, and the gavage cycle was 28 days.The electrical activity of cerebellar Purkinje cells induced by sensory stimulation was recorded by patch clamp amplifier and data acquisition software. Statistical analysis was conducted by Clampfit 10.3 software and SPSS 22.0 software, t-test and one-way ANOVA were used to compare the data between the two groups and the data before and after intervention of each group. Results:The electrophysiological results showed that the spontaneous simple spike discharge frequency of Purkinje cells in the cerebellar cortex of mice in ethanol group was lower than that of the control group ((26.8±2.5)%, (34.6±4.7)%; t=26.08, P<0.05), and the coefficient of variation was higher than that of the control group ((27.3±3.3)%, (19.2±2.3)%; t=22.95, P<0.05). After cerebral surface perfusion of GABAA receptor antagonist, the frequency of simple peak potentials in the cerebellar cortex of ethanol mice was higher than before administration ( t=10.19, P<0.05), and the coefficient of variation was lower than before administration ( t=28.36, P<0.05). After brain surface perfusion of GABAA receptor antagonist, there was no significant change in the spontaneous simple peak discharge frequency of cerebellar Purkinje cells in the control group( P>0.05), and the coefficient of variation decreased compared to before administration ( t=6.95, P<0.05). After administering AMPA receptor antagonists on the surface of the brain, there were no significant changes in the discharge frequency and coefficient of variation in both the ethanol group and control group compared to before administration (both P>0.05). After simultaneously blocking AMPA and GABAA receptors, it was found that the spontaneous discharge frequency in ethanol group increased after administration compared to before administration((107.3±4.3)%, (99.7±3.7)%, P<0.05), and the increased value of frequency in the ethanol group was also higher than that of control group ( P<0.05). After simultaneously blocking AMPA and GABAA receptors, the coefficient of variation of the alcohol group and the control group mice were both lower than those before administration (both P<0.05), and the decrease in the alcohol group was higher than that in the control group ( P<0.05). Conclusion:Chronic ethanol exposure significantly inhibited the spontaneous discharge of Purkinje cells in the cerebellum, and the enhancement of inhibitory components was achieved by the inhibitory input mediated by GABAA receptors.

Objective:To investigate the safety and efficacy of sacral neuromodulation(SNM)therapy for the treatment of lower urinary tract dysfunction(LUTD)in elderly patients.Methods:Clinical data of 91 elderly patients with LUTD from multiple medical institutions who received SNM during the period from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into four groups: the interstitial cystitis(IC)group(n=28), the neurogenic bladder(NB)group(n=36), the overactive bladder syndrome(OAB)group(n=13)and the idiopathic dysuria(ID)group(n=14). Different sets of evaluation parameters were used for different diseases.Patients’ baseline data and data in stage I(test phase)and stage Ⅱ(permanent SNM)were recorded, statistically analyzed and compared.Results:Ninety-one people underwent SNM treatment.Of them, 53 patients received permanent implants(stage Ⅱ), and the total conversion rate of stage I to stage Ⅱ was 58.2%(53/91). Patients receiving permanent implants(stage Ⅱ)had a preoperative period ranging from 3 months to 30 years, and were followed up for 2 to 58 months after treatment, with an average follow-up of 19.6 months.The improvement rates in stage I for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 35.4%, 31.6%, 33.7%, 32.6%, 49.2%, 43.2% and 13.2%, respectively.The improvement rates in stage Ⅱ for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 43.2%, 40.0%, 37.8%, 50.5%, 70.5%, 70.4% and 43.2%, respectively.Three adverse events occurred, including 1 case of recurrent symptoms, 1 case of moderate infection, and 1 case of electrical lead dislocation.Conclusions:Sacral nerve stimulation has definitive and consistent curative effects on LUTD in elderly people.The follow-up time should be extended to further study the safety of sacral nerve stimulation.