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.

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.

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

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.

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.

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.

In mass casualty incidents (MCI), the number of casualties can far exceed the capacity of medical emergency units to treat and transport in a very short period of time. A rapid MCI triage according to the severity of their injuries, can not only effectively use limited medical resources, but also improve the survival rate of injured patients. With the emergence of artificial intelligence (AI) and augmented reality (AR), smart glasses have been developed and used in different scenarios, and have achieved remarkable results in the medical field. This article focuses on the role and advantages of smart glasses in the triage of MCI, while proposing the problems in the application of smart glasses. At the same time, we elaborate on the development status of smart glasses in the triage, and discuss the application trend and development direction of smart glasses in the triage of pre-hospital injuries.

OBJECTIVE: To compare the features of caloric tests in vestibular migraine (VM) and Menière's disease (MD) patients, and provide objective evidence for differentiating the 2 groups of patients. METHOD: This case-control study included 11 MD patients with left ear involved and mild to moderate impaired hearing, and 18 matched cases with VM. All participants received caloric tests. Maximum slow phase velocities (SPVmax) were used to describe horizontal and vertical nystagmus respectively and were compared between the 2 groups. Horizontal and vertical canal parasis(CP) were calculated according to respective SPVmax. Unilateral (UW-VR) or bilateral (BW-VR) weakness of vestibular response, and positive unilateral (UVR) or bilateral (BVR) vertical response or negative bilateral vertical response (NBVR) were judged by the boundary point of SPVmax of 5°/s respectively. Total left (LV) or right (RV) Vertical reactions were calculated accoeding to vertical SPVmax,and inter ears difference of vertical responses (IED-VR) calculated from LV minus RV. RESULT: There were no significant differences in age and gender between the 2 groups. Horizontal SPVmax of all of caloric tests of VM group,except the left cold (LC), were statistically larger than that of MD group (P < 0.05) and the maximum responses of right warm (RW) caloric test in VM group (34.50 ± 17.77) were significantly greater than that in MD group (12.82 ± 6.69) (P < 0.01). Only the vertical SPVmax of RW of all caloric tests has statistically difference between the 2 groups (P < 0.01), and the maximum responses of RW caloric test in VM group (6.00 ± 4.45) were significantly stronger than that of LC in MD group (1.27 ± 2.00) (P < 0.01). Horizontal CP ≥ 25% of the 2 groups(VM: 72.22%, MD: 54.55%) were not statistically different, while the proportions of UW-VR and BW-VR in VM group (5.56%, 0) were significantly lower than that in MD group (27.27%, 18.18%) (P < 0.05). Vertical CP ≥ 25% of the 2 groups (VM: 94.44%, MD: 27.27%) were significantly different (P < 0.01), and the proportions of positive UVR (left: 5.56%, right: 77.78%) and BVR (0) and NBVR (16.67%) in VM group were significantly different from that in MD group (UVR (left: 9.09%, right: 0), BVR (0), NBVR (90.91%)) (P < 0.01). There was statistically difference between LV and RV in VM group (P < 0.01, LV < RV), while no difference were showed in MD group. IED-VR in VM group (left intenser: 16.67%, right intenser: 83.33%) was statistically different from that in MD group (left intenser: 36.36%, right intenser: 9.09%, both no difference: 54.55%) (P < 0.01). CONCLUSION Vestibular responses of caloric test are more sensitive, and vertical reactions are more easily induced in VM patients than in MD. Caloric test can be used to differentiate the 2 groups of diseases.
Caloric Tests ; Case-Control Studies ; Diagnosis, Differential ; Humans ; Meniere Disease ; diagnosis ; physiopathology ; Migraine Disorders ; diagnosis ; physiopathology

Objective To observe the effects of high-fat feeding on growth and the expression of insulin-like growth factor 1 (IGF-1),insulin receptor substrate 1 (IRS-1) in adolescent rats'liver with non-alcoholic fatty liver disease,and to elucidate the relationship between growth failure in adolescent rats with non-alcoholic fatty liver disease and IGF-1,IRS-1 turbulence.Methods Thirty-six Sprague-Dawley (SD) young rats of 21 days were randomly divided into normal control group(NC group,n =18) and high-fat feeding group(HF group,n =18).Non-alcoholic fatty liver disease(NAFLD) model was induced by feeding the SD rats with high-fat food.Immunohistochemistry was applied to detect the expression levels of IGF-1 and IRS-1 in liver tissue.The expressions of mRNA of IGF-1 and IRS-1 were measured by RT-PCR.Results Compared with NC group,the serum alanine amino transferase (ALT),total cholesterol (TC),triglyceride (TG) of HF group in the 6th,8 th,12th week were gradually increased.The serum ALT [(194.67 ± 11.15) U/L],TC [(1.81 ± 0.09) mmol/L],TG [(0.34 ± 0.05) mmol/L] contents of HF group at 8th week were higher than those at 6th week [(166.00 ± 22.01) U/L,(1.52 ± 0.22) mmol/L,(0.41 ±0.12) mmol/L,respectively],and the serum ALT[(213.0 ±27.67) U/L],TC[(2.15 ±0.37) mmol/L],TG[(0.38 ±0.15)mmol/L] contents of the 12th week were significantly increased compared with 6th week and 8th week.The constitution and body length of the HF group were lower than those of the normal control group.With time extended,the liver tissue steatosis,inflammation,the balloon like change of the liver tissue pathology of HF group in 6,8,12th week gradually increased.Immunohistochemistry results showed that HF group IRS-1 [(1.46 ± 0.23),(0.74 ± 0.17),(0.85 ± 0.31)],IGF-1 [(0.92 ± 0.02),(0.83 ± 0.02),(0.77 ± 0.03)] expression gradually decreased,the difference was statistically significant(F =36.024,P ＜ 0.05).IGF-1 and IRS-1 mRNA expressions in HF group were consistent.Conclusion The liver tissue IGF-1 and IRS-1 are correlated with the weight and body length.The growth failure of young rats induced by high-fat feeding may be related to the decreased expression of IGF-1 and IRS-1.