Objective: To predict the medical expenses and distribution of different medical payments of urban residents in Kunming, who are covered by the medical insurance scheme. Methods: We created a static micro-simulation model for predicting and evaluating the 2008-2010 medical insurance scheme for urban residents of Kunming. The main datasets used for constructing the model included: a 0.1% population sample dataset from the national census of 2000 and a dataset of urban employees and retirees under the social medical insurance scheme. Other data used in the model involved the aggregated results of 1% population survey of Kunming conducted in 2005. Results: Based on the population model of 2005, the population information and the data of employees and retirees covered by the social medical insurance scheme were integrated. The model provided information on resident incomes, medical expenses, medical expenses of outpatient services and severe illness; and the different kinds of payments could be forecasted by the model. Conclusion: Results of the present research can help the government in making relevant heath policies while ensuring the sustainable development of medical insurance scheme.

Objective: To investigate the population distribution according to different groups of people, the potential urban residents for medical insurance scheme, and to predict the income trends of individuals and families. Methods: An urban population model was created for China's medical insurance reform by using microsimulation modeling techniques. The first step was to construct the population structure for the period of 2005-2010, and update the Census sample population of 2000 to 2005-2010 according to the target population structure. Then the updated Census dataset was statistically matched with the individual dataset of insured employees and retirees. Results: The micro-population model for urban residents was constructed. The distribution of urban population with potential to enter the medical insurance was obtained by the constructed model. In addition, the distribution of family income was also obtained. The constructed model could be used for analysis and simulation of the major illnesses in the outpatient department and treatment procedure during hospitalization of insured residents. Conclusion: The findings of this research can help the government to take full consideration of the medical service demands of residents in making relevant medical insurance policies, so as to facilitate the sustainable development of medical insurance policies.

Objective To investigate the genetic susceptibility of HLA DRB1, DQB1 alleles to colorectal neoplasm in Hubei Han Chinese. Methods 54 patients with colorectal neoplasm and 136 healthy controls were examined for HLA DRB1 and HLA DQB1 genotypes, which were typed by using polymerase chain reaction/sequence specific primer (PCR/SSP) technique and allele sequence analysis.SAS(6.12 for win) was used for statistics. Results Compared with the control, the allele frequency (AF) of HLA DRB1*0901 (0.2315 vs 0.1397, P =0.033) and DRB1*080X(0.009 3 vs 0.080 9, P =7.11?10 -3 ) was significantly increased or decreased, respectively, in colorectal neoplasm of Hubei Han Chinese. And there was not significantly different between the patients with the control in the AF of HLA DQB1 alleles. Conclusion The results indicate that HLA DRB1*0901 allele is the positive association to , but DRB1*080X is the negative association to the patients of colorectal neoplasm among Hubei Han Chinese. The nucleotide sequences of these two alleles were identified by allele sequence analysis, approach to the corresponded allele sequence(exon 2)of genbank.There is not association HLA DQB1 alleles with the patients.

Objective To investigate the curative effect and nursing of children with cerebral palsy treated by cerebrovascular function treatment(CVFT).Methods Children with cerebral palsy(56 cases)were divided into the therapy group and the control group.They all received rehabilitation training and medication.The therapy group were treated with CVFT based upon routine treatmenL Results The effective rate in the thempy group was 96.5% and was 77.8% in the control group.There were statistical difference between the two groups(P＜0.05).Conclusions CVFY can improve the cerebral circulation,advance the blood-supply and oxygen-supply of injured cerebral tissue,alleviate the putrescence of cerebral tissue,accelerate the functional recovery of limbs of children with cerebral palsy,shorten the course of disease and improve the quality of children's life.

Adolescent ; Adult ; Aged ; Bone Marrow ; pathology ; Child ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; pathology ; Male ; Middle Aged ; Spleen ; pathology ; Young Adult

Objective:To investigate the polymorphism of HLA-DQA1 genes in Jing nationality of Central Vietnam.Methods:Applied PCR-SSP tecnique to determine the polymorphism of the HLA-DQA1 alleles of 105 healthy children and youth,unrelated individuals in Central of Vietnam.Results:10 HLA-DQA1 alleles were detected of which DQA1*0104 were the most common allele with frequency of 21.3% and lowest frequency is DQA1*0601.Conclusion:The results indicate that HLA-DQA1 alleles polymorphism of Jing nationality in Central Vietnam is different from the other Chinese. [

BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insufficiency (CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Since January 2010 to December 2012, 385 patients, who met the criteria of AECOPD, were enrolled in the Intensive Care Unit (ICU) of the First People's Hospital and Municipal Central Hospital of Xiangtan City. The AECOPD patients complicated with CIRCI screened by an adrenalcorticotrophic hormone test within 12 hours after admission to ICU were divided into a treatment group (n=32) and a control group (n=31) for a prospective, randomized and controlled clinical trial. Hydrocortisone (150 mg/d) or normal saline was injected intravenously for 7 days. The patients were followed up for 28 days after injection. The endpoint included 28-day survival time, non-shock time, ICU stay and the period of non-mechanical ventilation. The markers of inflammation C-reactive protein, tumor necrosis factor-α, interleukin 6 and procalcitonin were measured at baseline and 7 days after treatment. The variables were analyzed by Student's t test, the non-parametric statistical test, the Chi-square test or the Kaplan-Meier method with SPSS18.0 statistic software. A P value <0.05 was considered statistically significant. RESULTS: Totally 63 patients were diagnosed with CIRCI by an adrenalcorticotrophic hormone test and the prevalence rate was 16.4％. The shock rate of the AECOPD patients complicated with CIRCI was higher than that of the AECOPD patients without CIRCI (23.8％ vs. 8.7％, P<0.01). Kaplan-Meier analysis revealed that the 28-day survival time of the treatment group was obviously longer than that of the control group (P<0.05). Compared with the control group, shock-free days within 28 days was longer in the treatment group (18.2±9.5 vs. 25.8±4.1, P<0.05). Treatment with low-dose glucocorticoid obviously decreased the markers of infection and inflammation (P<0.01), such as C-reactive protein (13.2±5.5 mg/L vs. 8.3±3.1 mg/L for the control group; 13.5±5.9 mg/L vs. 5.1±2.3 mg/L for the treatment group), tumor necrosis factor-α (26.1±16.2 g/L vs. 17.5±11.7 g/L for the control group; 25.0±14.8 g/L vs. 10.4±7.8 g/L for the treatment group) and procalcitonin (3.88 g/L vs. 2.03 g/L for the control group; 3.77 g/L vs. 1.26 g/L for the treatment group). Furthermore, the markers in the treatment group decreased more obviously than those in the control group (P<0.01). CONCLUSION: The prevalence rate of CIRCI was higher in the patients with AECOPD in the department of critical medicine, and low-dose glucocorticoid treatment for one week reduced the 28-day mortality, shock time and markers of infection and inflammation.

Objective To observe the effectiveness of comprehensive rehabilitation on the recovery of motor function of patients with severe cerebral injury in recovery phase.Methods 72 cases with severe cerebral injury in recovery phase were randomly divided into rehabilitation group (n=38) and control group (n=34). Patients in control group were treated with routine method, and those in rehabilitation group with comprehensive rehabilitation treatment in addition.Results Motor function, activities of daily living (ADL) and complication of patients were evaluated at the first day and two months later after be in hospital. The effect of comprehensive rehabilitation treatment were better than that of control group(P<0.05,P<0.01). Conclusion Comprehensive rehabilitation is important to the patients with severe cerebral injury of recovering, not only in recovery of motor function but also in reducing the complication.

A 57-year-old man was admitted to the hospital for a 7-year progressively spreading plaques involving the entire body surface, and multiple irregularly sized red nodules and infiltrated patches on the face, trunk and limbs. Histopathological examination showed pleomorphic tumor cells diffusely dis-persed throughout the dennis, giving an appearance of low proliferation. Some cells with cytoplasmic pro-cesses appeared multiangular in shape, lmmunohistochemically, tumor cells were negative for CDla or S-100, but positive for CD45, FXIIIa, CDl4, MHC- Ⅱ, CD68 and lysozyme with extracellular interstitial expression. Ultrastructurally, the cells exhibited cytoplasmic processes and irregularly sized nuclei; no Birbeck granules were observed. Vesicules of low electron-density were seen diffusely in cytoplasm and extracellular matrix. The case is herein diagnosed as cutaneous non-Langerhans cell histiocytosis, which presents with a chronically invasive clinical course. These cells may develop from immature dermal dendritic cells.

Objective To study on the value and safety of early endoscopic retrograde cholangiopan-creatography (ERCP)and endoscopic sphincterotomy (EST) in acute biliary pancreatitis. Methods Ninety-two patients with acute biliary pancreatitis underwent early ERCP (within 72 hours) and received endoscopic therapy (ERCP group). Another 40 patients with acute biliary pancreatitis were treated conservatively without ERCP (control group). The disappearance of abdominal pain, decrease of serum amylase level, the mean days and costs of hospitalization and complications were observed in all patients. Results In ERCP group, all patients were performed EST, stones in 72 choledocholithiasis patients had been removed with net-basket or air pocket. Ten cases of severe acute biliary pancreatitis received endoscopic pancreatic duct stents drainage. Ninety two cases of acute biliary pancreatitis received endoscopic nasal catheter bile drainage. The days of the disappearance of abdominal pain, the decrease of serum amylase levels, the cost of the hospitalization and the days of the hospitalization were significantly shorter in the early ERCP group than in the control group. The mortalities in ERCP and control group were 8. 3% and 33. 3% respectively. Conclusion Early ERCP endoscopic therapy is a safe procedure has the superiorities in lowering the mortality, hospital days and expense.