Objective To identify the chief factors influencing health insurance patients' hospitali-zation expenses so as to provide basis for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods All the medical insurance cases involving the three disease entities in two hospitals of a certain city for the past three years, which totaled 647, were collected and a statistical analysis was made of the possible influencing factors using multi-stepwise regression analysis. Results The factors influencing the health insurance patients' hospitalization expenses included choice of hospitals, length of stay, performance of operations, proportion of drug fees, and province- wide readjustment of medical service prices. Reducing length of stay and lowering proportion of drug fees were the key to controlling expenses. Conclusion It is imperative to formulate scientific diagnostic and treatment routines and expense standards for single disease entities, speed up and deepen reform in the medical insurance system, and, on the basis of trying out payment based on certain single disease entities, implement payment based on disease entities.

Objective:To investigate the effect of mycophenolate mofetil(MMF)on proliferation and apoptosis of cyst-lining epithelial cells in patients with autosomal dominant polycystic kidney disease(ADPKD),and to compare its effect with that of rapamycin(RAPA)in vitro.Methods: Primary cultured cyst-lining epithelial cells were treated with MMF and RAPA at different concentrations(0,0.005,0.05,0.5,5 ?g/ml)for 48 h or 72 h.The inhibitory effects of them on the cells were evaluated by MTT assay;the cell cycle distribution and apoptotic ratio were determined by flow cytometry.The morphological changes of cyst-lining epithelial cells were observed under transmission electron microscope.Results: Both MMF and RAPA significantly inhibited the proliferation of cyst-lining epithelial cells in a dose-and time-dependent manner.After 48 h treatment,the cells were blocked at S phase by MMF and at G0/G1 phase by RAPA.Both drugs induced cell apoptosis,with the maximal apoptotic rate being(5.53?0.27)% for MMF and(4.36?0.10)% for PAPA.Typical morphological changes of apoptotic cells were observed under electron microscope.Conclusion: MMF can effectively inhibit proliferation and induce apoptosis of cyst-lining epithelial cells,but its inhibitory effect is weaker than that of RAPA.

Thiols, which are components of many proteins and simple molecules, play an important role in the cellular antioxidant defense system. The quantitative determination of thiols is important in biochemistry and clinical chemistry. Fluorescent probes, which have its apparent advantages in sensitivity and, most importantly, in imaging thiols in vivo, even in single living cells, appear to be particularly attractive. In this review, we classify the fluorescent probes based on their different reaction mechanisms with thiols and summarize the recent progresses of thiols fluorescent probes with fifty-one

BACKGROUND:The differentiation of neural stem cells (NSCs) is a hot research. Whether brain-derived neurotrophic factors (BDNF) can induce the differentiation of NSCs into neurons has not been detailed studied. OBJECTIVE:To investigate the effect of different concentrations of BDNF on the differentiation of NSCs from adult rat hippocampus into neurons in the medium with epidermal growth factor. DESIGN:A controlled study. SETTING:Department of Human Anatomy, China Medical University. MATERIALS:The experiment was performed at the Neurotomia Laboratory of China Medical University in August 2007. NSCs isolated from hippocampus of adult SD rats were inoculated in a serum-free medium. Three clean adult SD rats (200-250 g each) were provided by Laboratory Animal Department of China Medical University. Dispositions to the rats were consistent with ethical standards of animals. Epidermal growth factor (EGF) and BDNF were bought from R&D Company. METHODS:①NSCs obtained from rat hippocampus were cultured in the serum-free medium containing basic fibroblast growth factor (bFGF), EGF and B27. ②Single cell clone was obtained via limited dilution for the fourth passage of cells. Identification of NSCs for the passage of cells from monoclonal spheres was performed by Nestin immunocytochemistry. Neurons and astroglial cells were identified by immunocytochemistry for neuron specific enolase (NSE) and glial fibrillary acidic protein (GFAP) a week after differentiation. ③Differentiation for the monoclonal spheres was done to appraisal the proportion of neurons. NSCs were divided for several groups containing 0 μg/L, 50 μg/L, 100 μg/L, 150 μg/L, and 200 μg/L groups according to the doses of BDNF. EGF was added in the media of each group. Immunocytochemistry for NSE was done a week later to count the positive cells. MAIN OUTCOME MEASURES:Proportion of neurons differentiated from NSCs.RESULTS:①NSCs immunocytochemical staining showed that Nestin was positive in monoclonal spheres, and NSE and GFAP were positive in differentiated cells. ②The proportion of differentiation from NSCs into neurons was significantly higher in groups treated with 50 μg/L and 100 μg/L BDNF compared to other groups（t=2.502-5.025, P < 0.05）, but there was no significant difference between 50 μg/L and 100 μg/L BDNF groups（P > 0.05）. Moreover, no significant difference was detected among 0 μg/L, 150 μg/L and 200 μg/L BDNF groups (P > 0.05). CONCLUSION:The optimal concentration of BDNF is 50 μg/L for differentiation from NSCs into neurons while the concentration of EGF is 20 μg/L.

Objective To evaluate the effect of maternal separation stress on the behavior of neonatal rd mice.Methods Neonatal rd mice were divided into maternal separation (MS) group (n=9) and control group (n=9).MS-stress was induced in the MS group by 4-hour-separation per day for 28 days.Open field test,elevated plus maze test,forced swim test and tail suspension test were used to evaluate the anxiety-like and depression-like behavior of the neonatal rd mice.Results The stay time and distance travelled of MS group in the central zone were 0.88％ and 28.17±5.65 cm,respectively,significantly shorter than that of the control group (2.61％,109.9±9.79 cm.P =0.04,P =0.001).Compared with the control group,the stay time in open arms of the MS group was significantly decreased (P<0.01),while the immobility time in forced swim test and tail suspension test of the MS group were 126.5±10.22 s and 21.56±6.83 s,significantly longer than that of the control group (77.75±16.83 s,P =0.02,7.37±3.22 s,P =0.03).Conclutions The 28-day maternal separation stress can significantly increase the anxiety-like and depression-like behavior in neonatal rd mice.

OBJECTIVE To implement the automatic management of medical equipment.METHODS Based on the platform of net,three layers of C/S were applied with database technology to realize one-time importation of the basic information and current information,it made the information function of quantity evaluation,quantity determination,schedule formation,automatic alarm,apparatus distribution list,statistical inquiry,collection analysis,and information feedback coming to true.RESULTS By using one year,the application of management information system of medical equipment could meet the requirement in scientific and standardized supply,and standard,application and management of medical equipment.CONCLUSIONS It can be able to improve the system efficiency,reduce the labor and mistakes,and also achieve the aim that cannot be done by manual labor.

Based on the investigation and analysis of industry dynamics of health maintenance Applications (APP) of Traditional Chinese Medicine (TCM),the paper designs and develops health maintenance APP of TCM,and describes its architecture,operating principle,functions,innovativeness,applicability scope,etc.

Objective To systematically analyze and assess the overall value of transrectal shear wave elastograpy in diagnosis of prostate cancer (PCa) using Meta-analysis.Methods Relevant Chinese and foreign papers diagnosing PCa with transrectal shear wave elastograpy published before December 2016 were searched.The references were evaluated and screened according to the criteria of diagnostic research.The selected references were analyzed by Meta-Disc 1.4 and Stata 12.0 statistical software.Results Eight articles were included in the present Meta-analysis.Five of these literatures were about transrectal shear wave elastograpy in diagnosis of PCa,the summarized sensitivity (SEN) and summarized specificity (SPE) in diagnosis of PCa were 0.80 (95％CI [0.75,0.84]) and 0.75 (95％CI [0.71,0.79]),respectively;the positive likelihood ratios (PLR) and negative likelihood ratios (NLR) were 3.60 (95 ％ CI [2.57,5.05]) and 0.17 (95 ％ CI[0.08,0.37]),respectively;the area under SROC curves was 0.895.Five of these literatures were about transrectal shear wave elastograpy supplemental prostatic biopsy in diagnosis of PCa,the summarized SEN and SPE were 0.86 (95％ CI [0.83,0.88]) and 0.84 (95％CI [0.82,0.85]) respectively;the PLR and NLR were 5.81 (95％CI [3.07,10.99]) and 0.14 (95％CI [0.04,0.49]) respectively;the area under SROC curves were 0.924.Conclusion Transrectal shear wave elastograpy has better clinical value in detection of PCa and can be used to supplemental prostatic biopsy.

Background: Helicobacter pylori (Hp) infection is closely related to the occurrence of gastric cancer and other gastrointestinal and extra-gastrointestinal diseases. Detection and eradication of Hp infection is of great importance for prevention and treatment of the related diseases. Understanding the local Hp infection status may provide a reference for formulating targeted strategy for management of Hp infection. Aims: To investigate the current status and influencing factors of Hp infection in health examination population and outpatients in Baoshan District, Shanghai. Methods: Residents of Baoshan District for physical examination (including 13C-urea breath test, 13C-UBT) in Shanghai Ninth People's Hospital (North Branch), Shanghai Jiao Tong University School of Medicine from Jan. 2017 to Jan. 2018 were enrolled.Also, local outpatients of the same hospital for 13C-UBT from Aug. 2017 to Aug. 2018 were enrolled. The results of 13C-UBT were used for the study of Hp infection status, and a questionnaire survey was conducted in outpatients for understanding the influencing factors of Hp infection. Results: Altogether 5 164 health examination subjects were included, and the prevalence of Hp infection was 36.3%. Of the 800 questionnaires conducted in outpatients enrolled, 746 valid questionnaires were collected for analysis. The prevalence of Hp infection in outpatients was 58.0%. Univariate analysis showed that occupation, married, alcohol drinking, frequently taking meals outside, high salt/fat diet, smoked food, and family history of Hp infection were identified as the influencing factors for Hp infection (P<0.05). Conclusions: The prevalence of Hp infection in health examination population in Baoshan District, Shanghai is lower than the national average, however, the infection rate of outpatients is still relatively high. Eating separately, less taking meals outside, abstinence of wine, and light diet might be helpful for preventing Hp infection and its spreading.

ObjectiveTo explore the screening and therapeutic efficacy of primary carnitine deficiency (PCD) in newborns and mothers.Methods164245 newborns and suspected mothers were investigated for PCD by tandem mass spectrometry (MS/MS).The overall epidemiology,prognosis,and follow-up of the screening program were investigated.ResultsTotally 55 suspected cases were identified at the primary screening stage.Four newborns and three mothers were confirmed as cases of PCD.The incidence rate of newborns was 1 ∶ 40076.All the patients showed normal growth and development during the follow-up.Blood free carnitine level was raised in all three mothers after treatment.ConclusionsScreening for PCD with MS/MS in newborns may represent a valuable procedure in preventive medicine by enabling early diagnosis and treatment before the onset of symptoms.This protocol is also highly efficient and applicable in diagnosis of mothers with PCD.