Objective To investigate the potential factors that may be associated with clinical significant endoscopy findings (CSEF) and the characters of the appropriate patients for upper endoscopy.Methods Information of the out-patients was collected from the questionnaires that were performed before undergoing upper endoscopy from 26 September 2011 to 23 December 2011,including demographics characteristics,symptoms,gastroesophageal reflux disease questionnaire (Gerd Q) score,comorbidities,medication and purpose for upper endoscopy.The analyses were performed by Logistic regression to find the potential factors that were associated with CSEF.Results A total of 942 cases were enrolled.There were 471 (50.0％) patients with dyspepsia and reflux symptoms,300(31.8％)patients with dyspepsia and without reflux symptoms,and 86(9.1％)patients with reflux symptoms and without dyspepsia.Sum to 325 (34.5％) patients were diagnosed with CSEF,119(12.6％) with erosive esophagitis,28(3.0％) with Barrett esophagus,102 (10.8％)with peptic ulcers,66 (7.0％) with gastric dysplasia,and 13 (1.4％) with upper malignancy.Multivariate Logistic regression analysis showed that men (OR=1.677,95％CI:1.148 to 2.451),older age (OR=1.032,95％CI:1.021 to 1.044),alcohol intake (OR=1.761,95％CI:1.068 to 2.903),Gerd-Q score increase (OR=1.079,95％ CI:1.003 to 1.160),and presence of acid regurgitation (OR=1.659,95 ％CI:1.143 to 2.408) were significantly associated with increasing risk of diagnosis for CSEF,while taking proton pump inhibitors (OR=0.298,95％CI 0.109 to 0.818)was associated with lower possibility of detection.Conclusions Factors such as male,older age,alcohol intake,Gerd-Q score increase,presence of acid regurgitation and taking proton pump inhibitors,may have a certain significance for screening out patients and further improving the cost efficiency of gastroscopy.

10.3969/j.issn.1000-3606.2013.06.024

10.3969/j.issn.2095-4344.2013.23.015

Objective:The paper aims to evaluate the impacts of the urban residents’ basic medical insurance on the medical treatment and preventive care services utilization through quantitative evaluation. Methods:The China Health and Nutrition Surveys ( CHNS) Data collected from 2006 to 2011 were used to compare the difference between medical treatment and preventive care services utilization adopting the difference-in-difference method and the Probit model. The control group urban residents did not participate in the basic medical insurance while their treatment group participated. Results:The medical treatment and preventive care services utilization were more for the treat-ment group than they were for the control one. The age, education level, annual per capita income and hypertension influenced the medical services utilization, and the annual per capita income was a protective factor. The age and ed-ucation level also influenced the preventive care services utilization. Conclusion: The urban resident basic medical insurance plays an important role in the medical treatment and preventive care services utilization. Meanwhile, this factor continuously enhanced the coverage and the per capita income protection for medical services.

Objective:To explore grouping methods of subdividing adjacent diagnosis related groups(DRGs) by introducing patient clinical complexity level(PCCL) principle and provide references for exploring DRG grouping method in line with context in China.Methods:Clinical complexity level of each complication was assigned by clinicians.PCCL model was selected to calculate the scores of clinical complexity cases.Each adjacent DRG was subdivided into DRG groups by classification and regression trees(CART) model.The rank-sum test was applied to test the statistical significances of the grouping results.Results:9 surgical adjacent DRGs were subdivided into 18 DRG groups.There were statistical significances in the differences of hospitalization expenses and length of stay among different DRG groups in each adjacent group.Conclusion:PCCL model showed high performance in DRG subdivision.The unification of the quality of medical records and coding were the key factors to ensure the reasonable grouping results.

Background and purpose:miR-17-92 gene cluster overexpression has been observed in various cancers, such as lung cancer, liver cancer, gastric cancer and prostate cancer. In this study, we established the stable cell line overexpressingmiR-17-92 to explore the inlfuence ofmiR-17-92 on the migration, invasion abilities and cisplatin resistance of the prostate cancer DU145 cells.Methods:miR-17-92 overexpression vectors were constructed. DU145 cells were infected with the viral supernatants produced by Phoenix A packaging system. Real-time lfuorescent quanti-tative polymerase chain reaction (RTFQ-PCR) was conducted to detect the expression level of miR-17-92 in the cells. The migration and invasion abilities were measured by a real-time xCELLigence system. The scratch healing assay was carried out to investigate the migration abilities. The expression of integrin β1 was detected by Western blot, and the activities of matrix metalloprotein-2 (MMP-2) and matrix metalloprotein-9 (MMP-9) were measured by gelatin zymography experiment. The cell growth of the two cell lines after the treatment of cisplatin was detected by a real-time xCELLigence system. The mRNA expression ofERCC1 was measured by RTFQ-PCR. Western blot was conducted to investigate the protein expressions of ERCC1, ERK1/2 and pERK1/2.Results:DU145-miR-17-92 cells migrated faster than DU145-control cells during the 24 h continuous monitoring (P<0.01). The scratch healing assay indicated that DU145-miR-17-92 cells migrated from the edge towards the scratch center faster than DU145-control cells. DU145-miR-17-92 cells invaded through matrigel markedly faster than DU145-control cells (P<0.01). The protein expression level of integrin β1 and the MMP-9 activities in DU145-miR-17-92 cells were increased than those in DU145-control cells. After the treatment of cisplatin, DU145-miR-17-92 cells grew faster than DU145-control cells, presenting cisplatin resistance (P<0.01). The phosphorylation of ERK1/2 in DU145-miR-17-92 cells was constantly at a high level regard-less of the treatment of cisplatin. Compared with DU145-control cells, the expression of drug resistance-related gene ERCC1 was dramatically increased in DU145-miR-17-92 cells after the treatment of cisplatin.Conclusion:miR-17-92 overexpression increases the migration and invasion abilities of the prostate cancer DU145 cells, which is associated with the upregulated expression of integrin β1 and the increased activity of MMP-9. Besides,miR-17-92 overexpression enhances the cisplatin resistance of DU145, which is correlated with the increased phosphorylation level of ERK and the upregulated expression of ERCC1 at both the mRNA and protein levels.

Aim To study the absorption kinetics of se-ries molecular weight 5-ASA-mPEG in rats intestine. Methods The in situ intestinal absorption property of 5-ASA-mPEG in rats was investigated by means of sin-gle-pass perfusion, and HPLC method was established to determine the drug concentration in the perfusate. Results The drug concentration and the site of intes-tine segments had little effect on the drug absorption constant ( Ka ) and apparent absorption coefficient (Papp). The perfusion flow rate and the variable mo-lecular weight of 5-ASA-mPEG could significantly af-fect the Ka and Papp. Conclusion 5-ASA-mPEG can be absorbed at all segments of the intestine of rats and has no specific absorption site. It is preliminarily in-ferred that the absorption mechanism of 5-ASA-mPEG is passive transportation. The intestinal absorption of 5-ASA-mPEG shows a downward trend with the increase in molecular weight. The results shows that the modifi-cation of 5-ASA by PEG can effectively inhibit the in-testinal absorption of mesalazine.

Objective To investigate the changes of plasmacytoid dendritic cells (pDC) in peripheral blood of patients with systemic lupus erythematosus(SLE) and its roles in the pathogenesis of SLE.Methods The level of pDC and the expressions of CD32,CD40,CD86,CD62L and CXCR4 were analyzed by flow cytometry.The concentrations of IFN-α in serum were detected by ELISA assay.Results The levels of circulating pDC were significantly decreased in SLE patients compared with healthy controls.Moreover,the pDC levels in active SLE patients were lower than those in inactive SLE patients,and compared with the primary group,the pDC levels were increased in the treatment group.The levels of pDC showed a significant decrease in SLE patients with arthritis,proteinuria or leucopenia in comparison with patients without those manifestations,showing a negative correlation with proteinuria.The expressions of cell surface molecules including CD32,CD86,CD62L and CXCR4 on pDCs were significantly increased in SLE patients compared with healthy controls,and the levels of pDC were negatively correlated with the expressions of CD32 and CXCR4 in patients with SLE.The concentrations of IFN-α in serum of patients with SLE were significantly higher than those in healthy controls,and the levels of pDC were positively correlated with the concentrations of IFN-α in patients with SLE.Conclusion The level of circulating pDC in patients with SLE was remarkably reduced,but the expressions of molecules involved in cell activation and migration were upregulated,accompanied by enhanced IFN-α production,which might promote the onset and progression of SLE.

Objective To evaluate the risk factors for prognosis in liver cirrhotic patients with acute esophageal variceal bleeding (EVB). Methods Retrospective analysis was carried out in patients with liver cirrhosis,who were admitted to the hospital for EVB between January 2000 and December 2006 . All patients were follow-up to August 31st, 2009. The death of the patients was identified as the end of the study. The vital signs and results of laboratory tests were recorded when patients were admitted to the hospital. Child-Pugh score/grade, model for end stage liver disease (MELD) score and Rockall score were calculated. Results Ninty-five cases (66 males and 29 females) were enrolled in the study. Among them, 60 cases died and 35 cases survived for (42. 61±33.21) months (ranged from 2 days to 114 months). Univariate Cox regression analysis showed that age, male, Child-Pugh score/grade, MELD score, Rockall score, white blood cell counts and active hepatitis B were risk factors for death in liver cirrhotic patients with EVB (P＜0.05), while high level of hemoglobin and high hematocrit, endoscopic variceal sclerosis therapy or surgical treatment were protective factors (P＜0.05). Multivariate Cox regression analysis revealed that Child-Pugh grade (RR= 4. 997,95%CI:2. 787～8. 960, P＜0.01),Rockall score (RR= 1. 284,95%CI:1. 062～1. 553,P=0. 010), high counts of white blood cells (RR= 1. 072,95%CI: 1. 001 ～ 1. 148, P= 0. 046) were risk factors for prognosis of liver cirrhotic patients with EVB. Conclusion It is demonstrated that Child-Pugh grade,Rockall score and high counts of white blood cells are risk factors for prognosis of liver cirrhotic patients with EVB.

Time to positivity(TTP) is a new parameter in blood culture field.The article shows us the concepts of TTP,differential time to positivity (DTTP),and introduces their relation with bloodstream infection (BSI),catheter-related bloodstream infection (CRBSI).Besides,it stresses TTP' s clinical application,including determining the severity of disease;identifying the isolates whether pollution or not; identification of isolate strains ; detection of the drug resistance of isolates ; evaluating the effect of antibiotic ; helping to adjust the therapeutic drug; diagnosing or excluding CRBSI by means of DTTP;deciding whether the catheter is the source of infection in patients with candidemia; understanding the epidemiological distribution of strain.At the same time,the article also describes the shortcomings and domestic current status.