Objective:To investigate the relationship between mild cognitive impairment (MCI) and body mass index (BMI) in older adult patients with type 2 diabetes mellitus (T2DM).Methods:A total of 327 patients with T2DM who received treatment in Wuyunshan Sanatorium from January 2016 to May 2019 were included in the T2DM group. Patients in theT2DM group were subdivided into an MCI group ( n = 73) and a non-MCI group ( n = 254) according to whether they had MCI. An additional 100 older adult volunteers who concurrently received physical examination were included in the control group. Sex, age, years of education, monthly family income, body mass index, living habits (drinking, smoking) and laboratory indexes were compared among the groups. The influential factors of MCI in patients with T2DM were analyzed by logistic regression model. The predictive value of BMI for MCI in older adult patients with T2DM was evaluated by receiver operating characteristic (ROC) curve. Results:Age, monthly family income, the proportion of patients with a history of diabetes mellitus, BMI, fasting blood glucose, glycosylated hemoglobin (HbA1C), low-density lipoprotein cholesterol (LDL-C) in the T2DM group were (73.10 ± 9.56) years old, 8 926 yuan RMB, 189/327, (24.18 ± 2.64) kg/m 2, (6.96 ± 0.88) mmol/L, (7.10 ± 0.84)%, (7.32 ± 0.84) mmol/L, respectively, which were higher than those in the control group [(68.28 ± 8.21) years old, 6 715 yuan RMB, 13/100, (22.30 ± 1.74) kg/m 2, (4.51 ± 0.72) mmol/L, (5.62 ± 0.68)%, (7.04 ± 0.67) mmol/L, t = 4.554, χ2 = 18.601, 61.654, t = 6.668, t = 25.360, 16.077, 3.049, all P < 0.05]. In the MCI group, the proportion of patients having a monthly family income < 5 000 yuan RMB, the proportion of patients having a history of diabetes mellitus, BMI, HbA1c value were 29/73, 60/73, (24.92 ± 2.43) kg/m 2, (7.54 ± 0.88)%, respectively , while they were 70/254, 129/254, (23.77 ± 2.59) kg/m 2, (6.92 ± 0.81)%, respectively in the non-MCI group. There were significant differences in these indexes between MCI and non-MCI groups ( χ2 = 6.144, 22.927, t = 3.389, 5.652, all P < 0.05). Multivariate logistic regression analysis showed that BMI and HbA1c were the influential factors of MCI complicated by T2DM in older adult patients ( OR = 0.274, 0.192, both P < 0.05). Monthly family income and family history of diabetes mellitus were not closely related to the development of MCI in older adult patients with T2DM ( OR = - 0.154, 0.093, both P > 0.05). The ROC curve revealed that when BMI value was 24.49 kg/m 2, Youden index was the largest (0.510), the corresponding sensitivity was 83.86%, and the specificity was 67.12%. The area under the ROC curve was 0.766 [95% CI (0.699 - 0.832)]. Conclusion:BMI is an influential factor of MCI development in older adult patients with T2DM, and may be one of the important indicators for early prediction of MCI.

By using the diagnosis related groups(DRGs) method, we analyze and compare the rationality and feasibility of outcomes and human resources distribution of clinical specialties and health care professionals.It may increase the hospital management levels and feasibility.The introduction of DRGs for the majority of hospital management may enhance the performance evaluation and human resource levels in the hospitals.

Objective Taking the respiratory department of internal medicine as an example, to compare the coverage of clinical treatment of the MDC covered by DRGs of Beijing version with the professional services offered as secondary clinical treatment subjects in China.Methods Using the data from medical record home page from hospitals in Beijing above secondary level from 2012 to 2014 and both the DRGs defined in Pareto diagram statistical method and the DRGs proved by experts, for analysis and definition of the DRGs coverage involved by respiratory discipline of internal medicine.Results Respiratory discipline of internal medicine involved DRGs of 42 groups as found by the two methods.Conclusion The DRGs scope of secondary clinical departments in hospitals should be made based on both expert consultation and clinical data statistics method.

Objective:To explore the regulatory effect of glutathione S-transferase P1(GSTP1) on the radiosensitivity of mouse Lewis lung cancer (LLC) cells.Methods:GSTP1-shRNA lentivirus and negative control lentivirus were used to respectively infect the LLC cells, and stable transgenic strains were selected. Real-time PCR and Western blot were conducted to quantitatively measure the expression levels of GSTP1 mRNA and protein in the LLC cells to verify the knockdown effect. The cell counting kit-8(CCK-8) assay was used to detect cell viability after irradiation. The colony formation assay was utilized to assess the cell proliferation ability after irradiation. Flow cytometry was performed to assess the level of cell apoptosis after irradiation. The tumor-bearing mice were established and irradiated to detect the changes in the tumor volume after irradiation. TUNEL staining was employed to detect the level of tumor apoptosis after irradiation. Immunofluorescence was used to detect the number of CD 4+ CD 8+ T cells in the tumor after irradiation. Results:Real-time PCR and Western blot showed that after shRNA lentivirus interference, the expression levels of GSTP1 mRNA and protein were significantly down-regulated. Down-regulation of GSTP1 reduced cell viability and proliferation, and increased the rate of cell apoptosis after irradiation. The tumor volume of the tumor-bearing mice after irradiation in the GSTP1 knockdown group was significantly smaller than that in the NC group, whereas the tumor apoptosis rate was significantly higher and the number of infiltrating CD 4+ CD 8+ T cells in the tumor was remarkably higher compared with those in the control group. Conclusion:Knockdown of GSTP1 can significantly increase the radiosensitivity of LLC cells and enhance the infiltration of lymphocytes in tumor tissues.

Objective To observe the clinical therapeutic outcomes and the radiographs changes of lumbar degeneration disease treated by dynamic stabilization device (Wallis). Methods Eighty-four cases of lumbar degeneration disease were treated by threaded fusion cage, from May 1997 to May 2002. The JOA scores, the rate of fusion,cage sink and adjacent segment degeneration were observed. Results The average hospitalizotion was 23.59 days. The mean operation time was 3.00 hours. The mean JOA scores were 13.93 before the operation,while 26.69 on the end of the following time respectively; there was statistical significant. The mean motion of operative segment was 5.22 before operation, while 2.44 on the end of the following time respectively. The mean extension of operative segment was 3.32 before operation ,while 1.39 on the end of the following time respectively. The mean motion of adjacent segment was 3.68 before operation, while 6.54 on the end of the following time respectively. The mean extension of adjacent segment was 1.95 before operation,while 3.95 on the end of the following time respectively. There were all statistical significant on those changes of Cobbs angel. Conclusions The long-term therapeuptic effect of WALLIS treatment for lumbar degeneration disease is reliable. The motion of operative segment was significant decreased, especially on extension. The motion of adjacent segment was significant increased, the degree extension of adjacent segment was also significant increased.

2013 witnessed the full coverage of the medical insurance lump-sum prepayment management at all hospitals above secondary level in Beijing.As a result,medical insurance management of the hospital turned its focus from“ expense settlement” to“ expense management”,with a multidimensional,multi-method,multi-sectoral and multi-index lump-sum prepayment of medical insurance management system set up.Methods and concepts introduced included diagnosis related groups (DRGs) management tools in hospitalization service management; equivalent hospital departments comparison in outpatient service for post management; the concept of total budget management concept,and the “market-operations-finance-performance” linkage mechanism for priority control of drug expenses; and focused management on key patient groups and drug/consumable suppliers.

Objective To analyze the applicability of case mix index (CMI) in medical performance evaluation of different type of hospitals and its calculation method.Methods Standardized adjustment to the CMI value of hospitals according to the CMI of the main disease categories (MDC) of short-term inpatient cases of the city, to align the CMI values of various hospitals with their levels of medical and technical services.Results The said adjustment ensures the CMI value to better represent the levels of such hospitals.Conclusion The adjusted CMI calculation method can provide accurate data support for various hospitals' performance evaluation.

The hospital designed a new business process according to the business process reengineering theory and requirement of Diagnosis Related Groups-prospective payment.This new process has scored good outcomes following adjustment of department functions,staffing and equipment installation,as well as process optimization,and policy explanations.

Objective: To investigate the prevalence and association of hyperuricemia (HUA) and hypertriglyceridemic Waist (HTW) phenotype in children and adolescents aged 6-17 years in Inner Mongolia, providing a basis for the prevention and treatment of hyperuricemia in adolescents in Inner Mongolia. Methods: A total of 2 175 students of primary, junior high, and senior high school students from eight counties (districts) in Inner Mongolia were chosen and received a questionnaire survey, physical examination, and laboratory test by used a multi stage stratified random sampling approach. The association between the HTW phenotype and HUA was analyzed using binary Logistic regression. Results: The prevalence of the HTW phenotype was 2.1%, with boys(2.5%) higher than that of girls(1.6%) ( χ 2=14.50, P<0.05). The average SUA level of the participants was 308.00 (259.00, 371.00) mmol/L, with a statistically significant sex difference(Z=-9.87, P<0.05). The prevalence of HUA was 21.1%. The frequency of HUA in the HTW phenotype(44.4%) was higher than in other phenotypes, followed by enlarged waist (EW) phenotype. After controlling for associated variables, the EW phenotypes (OR=1.76，95%CI=1.26-2.47) and HTW phenotypes (OR=2.25, 95%CI=1.12-4.52) were associated with higher risk for HUA(P<0.05). Conclusion In Inner Mongolia, the prevalence of HUA in children and adolescents aged 6-17 years is high, and there shows a positive association between the HTW phenotype and hyperuricemia. For the prevention of hyperuricemia, more attention should be paid to children and adolescents with HTW phenotype.

Objective: To explore the correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia, so as to providing a scientific basis for guiding rational vitamin D supplementation among primary and middle school students in Inner Mongolia Region. Methods: A total of 2 206 students of primary and middle school students from 8 counties (districts) in Inner Mongolia were enrolled for a questionnaire survey, physical examination, and laboratory test by a multi stage stratified random sampling approach.The levels of fasting blood glucose, blood lipid and other related indexes with different vitamin D levels were analyzed, and their correlation was further discussed. Results: The deficiency and insufficiency rates of vitamin D among primary and middle school students were 33.2% and 42.8%, respectively, and the suitable rate was 24.0%. The body mass index (BMI) and waist height ratio (WHtR) of the vitamin D deficiency group [(22.87±7.41) kg/m 2 , 0.46±0.08)]were higher than the insufficiency [(20.59±8.00)kg/m 2, 0.44±0.09)] and suitable group [(18.01±7.38)kg/m 2, 0.43 ±0.08)] ( P <0.05). Compared with the vitamin D suitable group [(3.87±0.85) mmol/L], the total cholesterol (TC) level in the deficiency group [(3.73±0.67)mmol/L] decreased, with a statistically significant difference ( P <0.05). The levels of high density lipoproteins (HDL) in the vitamin D insufficiency[(1.40±0.33)mmol/L] and deficiency groups [(1.34±0.31)mmol/L] were lower than the suitable group [(1.48±0.34)mmol/L], with a statistically significant difference ( P <0.05). The detection rate of hyperuricemia (HUA) in the vitamin D deficiency group (22.95%) was higher than the suitable group (17.20%), with a statistically significant difference ( P <0.016 7). Pearson correlation analysis showed that vitamin D was negatively correlated with BMI and WHtR ( r =-0.23, -0.11), and positively correlated with TC and HDL level ( r =0.06, 0.16) ( P <0.05). Conclusions The deficiency and insufficiency rates of serum vitamin D among primary and middle school students in Inner Mongolia are high which are associated with several indicators of blood lipids. Therefore, it is recommended to supplement vitamin D preparations in moderation in daily life.