Objective: To analyze the hospitalization expense and management status of severe mental illness, and to provide evidences for rational controls of medical expenses and the management of the patients. Methods:Collecting patients with severe mental illness from 2005 to 2012, analyzing the changing trends of hospitalization cost and management status with descriptive analysis, and use multiple linear regression to analyze the influence factors. Results: The average stay is 51 days, average medical costs by person and by day are RMB 8 319.69 and 169.02; treatment costs, drug costs and bed care costs are the main proportion. The medical costs were significantly affected by prolonged days of hospitalization, age, numbers of hospital admissions, nursing level and admitting diagnosis. The largest proportion of management system is schizophrenia, which counted 74.03% of current patients and the poverty incidence rate is 50.62%. Conclusions: Increasing the financial compensation to patients with severe mental illness, shorting hospital stay, strengthening the screening of patients with severe mental illness and incorporated into the management system would help to reduce the economic burden of the patients.

Objective To explore the best procurement technology for cadaveric donor nephrectomy. Methods Clinical data of 1 439 donors nephrectomy in the past 24 years were retrospected.Bilateral nephrectomy,en bloc removal of both kidneys and en bloc removal with in situ cooling both kidneys were adopted in different periods of time.Operation time(OT),hot ischemia time(HIT),cold ischemia time(CIT),total ischemia time(TIT), renal graft beginning to produce urine time after revascularization(UT),renal function recovery time(RRT), damage rate(DR),quantity of preservation solution(PS), rate of acute tubular necrosis(ATN),primary non function(PNF) and poor perfusion of donor kidney(PPK) were observed and comparad among the 3 techniques. Results 216 cases were accomplished by bilateral nephrectomy and 432 kidneys were procured.1 134 cases were accomplished by en bloc removal and 2 264 kidneys were procured(4 cases had only one kidney each).Eighty nine cases were accomplished by en bloc removal with in situ cooling and 178 kidneys were procured. HIT of these three techniques (bilateral nephrectomy,en bloc removal and en bloc removal with in situ cooling) were 8.22?3.01min?5.35?1.88min?1.89?0.92min ( P 0.05).UT were ( 28.24 ?10.65)min,(22.72?8.35)min,(9.26? 10.95 )min.RRT were (9.98?6.84)d,( 7.59 ?6.35)d,(4.91? 7.68 )d.ATN were 15.40%,7.31%,3.98%( P

Objective To study the correlated mechanisms and clinical effect of hidden hemorrhage after total hip arthroplasty (THA) and total knee arthroplasty(TKA). Methods From March 2001 to May 2005, 61 patients were treated with THA and 73 patients were treated with TKA. The patients treated with THA involved 22 males and 39 females with an average age of 68 years(range 61-79 years). The patients treated with TKA involved 23 males and 50 females with an average age of 73 years(range 65-77 years). All arthroplasties were primary and unilateral, and the 24 h fluid resuscitation was not more than 2000 ml. Using Gross formula, the true total blood loss was calculated depending on height, weight and pre- and post-operation Hct, and the hidden hemorrhage was got by subtracting the visible blood loss from total loss. Results Following THA, the mean total loss was 1520 ml and the hidden hemorrhage 482 ml(32%). Following TKA, the mean total loss was 1508 ml and the hidden hemorrhage was 776 ml(52%). The difference of hidden hemorrhage between THA and TKA was significan different(P

Objective To explore the preliminary experience of combined liver-kidney transplantation.Methods Twelve patients were subjected to combined liver-kidney transplantation. The orthotopic liver transplantation was preceded with the classic fashion in 8 patients and the piggyback fashion in 4 patients. The pump-driven veuovenoas bypass technique was not used. And then the kidney transplantation was performed under stable homodynamic circumstance. The renal graft was implanted to the right iliac fossa routinely. The renal vein was anastomosed to the external iliac rein end-to-side, and the renal artery to the external iliac artery end-to-side or the hypogastric artery end-to-end. After operation, anti-CD25 monoclonal antibody or antithymocyte globulin (ATG), tacrolimus (FK506), mycophenolate mofetil and prednisone were used to prevent the allograft rejection.Results The survival rate of the 12 cases receiving combined liver-kidney transplantation was 100 %, and the graft function was restored well postoperation. An acute rejection episode of liver occurred in one patient. The FK506 toxicity occurred in one patient. The hemorrhage of digestive tract occurred in one recipient and the hemorrhage of peritoneal cavity in one patient. The pneumonia occurred in one case and the peritoneal infection in one patient. No patient experienced any episode of acute rejection of renal allograft.Conclusions The combined liver-kidney transplantation is the ideal option of patients with end-stage liver disease with chronic renal failure.

Purpose To detect whether a 3243 point mutation existed in age related macular degeneration (AMD). Methods Twenty six cases of wet form AMD patients, ten cases of dry form AMD patients were selected,and compared with twenty nomal controls. After collecting anti coagulated blood samples, total cellular DNA were extracted and purified. Using polymerase chain reaction and restriction fragment long polymorphism techniques, the mtDNA A→G point mutation at position 3243 were detected. Results After cleaveded by restriction endonuclease Apa I, a 294 bp fragment remained only in all detected DNA samples including twenty six wet form AMD, and ten dry form AMD. No any other fragment appeared. The result showed that there was no A→G mutation at position 3243 found in AMD. Conclusion It is suggested that mtDNA 3243 point mutation due to maternal inheritance might be not concerned with both wet form AMD and dry form AMD.

Adolescent ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Blood Pressure ; drug effects ; Child ; Child, Preschool ; Female ; Fosinopril ; pharmacology ; therapeutic use ; Humans ; Male ; Nephritis ; drug therapy ; Proteinuria ; drug therapy ; Purpura, Schoenlein-Henoch ; complications

Objective To explore the relationship between plasma brain natriuretic peptide(BNP),endothelin-1(ET-1)and left ventricular end diastolic volume index(LVEDVI),left ventricular ejection fraction(LVEF)in children with heart failure and their clinical significance.Methods Forty-one children with heart disease were divided into Ⅰ,Ⅱ,Ⅲ and Ⅳ groups according to New York Heart Assciation(NYHA)heart functional class.Plasma BNP and ET-1 concentration were determined before and after treatment.All patients had echocardiographic study,including measurement of LVEDVI and LVEF.The relationship between plasma BNP,ET-1 and LVEDVI,LVEF were studied.Twenty healthy children were included in healthy control group,plasma BNP and ET-1 concentration were also determined.Results 1.Plasma BNP and ET-1 concentration in children with heart failure were significantly higher than those of healthy control group,and increased with the degree of heart failure.2.Plasma BNP and ET-1 concentration in children with heart failure were positively correlated with NYHA heart functional class(r=0.70,0.61 Pa

Objective To study kidney transplantation in the aged and its perioperative management. Methods Scrutinized screening of heart,lung and liver were carried out before renal transplantation for 29 patients,aged 65～84.Color Doppler B type ultrasonic inspection was used to determine the status of arteriae iliaca externa and arteriae iliaca interna.Tissue match included HLA and PRA measurement.Warm ischemia time of donor kidney was within 5 minutes and cold ischemia time 10 hours.The dose of MP was under 2.0 g during the period of operation and the immunosuppressive regimen was CsA or FK506+MMF+Pred.The general condition,blood electrolytes,whole blood CsA or FK506 concentration and immune index were monitored. Results There were 4 cases of AR,1 cases of FK506 toxicity and 1 case of lung infection.All these 6 patients were cured.1 kidney graft was removed because of thrombogenesis of renal artery.Up to now,the other 28 have been surviving with the graft functioning well for 1 to 5 years. Conclusions Abide to the indications of kidney transplantation,donor kidney of good quality and well tissue match were important in the elderly patients.With comprehensive monitoring and adequate management,kidney transplant in old patients can achieve sa tisfying outcome.Rational application of immunosuppressants and effective long term follow up are major factors for long term allograft survival.

Objective To explore the short-term and long-term efficacy of laparoscopic versus open liver resection(LLR)in the treatment of hepatocellular carcinoma(HCC). Methods The perioperative and follow-up data ofLLR(n = 43)and OLR(n = 73)for the treatment of HCC at the same period were analyzed respectively. Results There were no significant differences in the age,gender,Child-Pugh classification,liver cirrhosis, AFP,and hepatic virus affection between the 2 groups. 1 case in the LLR group was converted for the open surgery and another one case in the OLR group died in the perioperative time. However ,compared with OLR group ,the intraoperative blood loss of LLR group(P < 0.05)was larger and the mean operative time(P < 0.05)was longer. The liver function indicators of the regular hepatectomy subgroup were recovered more quickly(P<0.05),but the indicators of remaining subgroups were not significantly different. The postoperative ambulation time (P < 0.05), the postoperative eating time(P < 0.05),the postoperative hospital stay(P < 0.05)were all shorter. The VAS score was lower(P<0.05). There was no difference in the incidence and distribution of complications and the inci-dence of severe complications between the two groups(all P>0.05). The first and third year disease-free survival rates were 82.2%,53.8%for LLR and 91.5%,75.9%for OLR,respectively(χ2=0.55,P=0.46). The first and third 5 year overall survival rates were 94.2%,79.3%for LLR and 94.9%,47.3%for OLR,respectively(χ2=1.06, P=0.30). Conclusion LLR for HCC treatment is a safe and effective way with the advantages of minimal opera-tive trauma,quick recovery and significant short-term efficacy.

OBJECTIVETo investigate the changes in the levels of monocarboxylate transporter-2 in spinal cord horn in a rat model of chronic inflammatory pain.

METHODSMale SD rats weighting 180 - 220 g were randomly divided into two groups(n = 48): normal saline group (NS group), complete Freund's adjuvant group (CFA group). Rats were given injections of CFA 100 µl in left hind paw in group CFA, and an equal volume of saline was given injection in group NS. Mechanical withdraw threshold(MWT) and thermal withdraw latency(TWL) were measured at before injection(T0 and 3 h, 1 d, 3 d, 7 d, 14 d, and 21 d after injection(T1-7). Four rats were chosen from each group at T0-7 and sacrificed, and L4-5 segments of the spinal cord horn were removed for measurement of the expression of monocarboxylate transporter-2 by Western blot analysis.

RESULTSIn CFA group, mechanical hyperalgesia and allodynia appeared on the 3 h after CFA injection, then until the day 14. The expression of monocarboxylate transporter-2 in the spinal dorsal horn of rats in CFA group was significantly higher than that in normal control group at T1-6(P <0.05). The protein level of monocarboxylate transporter-2 was apparently correlated with MWT and TWL(P <0.01 and P <0.05) in CFA group.

CONCLUSIONThe level of monocarboxylate transporter-2 in spinal dorsal horn is significantly increased in a rat model of chronic inflammatory pain and the change may involve in the formation and maintenance of central sensitization in spinal cord of chronic inflammatory uain.

Animals ; Disease Models, Animal ; Freund's Adjuvant ; Hyperalgesia ; chemically induced ; Inflammation ; chemically induced ; metabolism ; Male ; Monocarboxylic Acid Transporters ; metabolism ; Pain ; chemically induced ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spinal Cord ; metabolism ; physiopathology