Medical assistance systems are an integral part of the health security system and they represent the integrity and adequacy of health risk protection. The overwhelming majority of developed countries have already es-tablished medical assistance systems to improve the accessibility of healthcare services and provide catastrophic pro-tection for families, especially for the poor. The paper conducts a comparative study of typical foreign medical assis-tance systems, where in the general method by which developed countries embed catastrophe protection mechanisms into public healthcare security systems and provide tilt protection to the needy is described. Medical assistance is pro-vided on a means-test basis and the development of private health insurance is encouraged to alleviate pressure on the public side. Corresponding implications for China are also warranted, including the provision of tilt protection to the needy, to re-define objects and standards of medical assistance, and enhance the coordination of different medical se-curity systems.

Objective To evaluate the role of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (ACCP) and anti-keratin antibody (AKA) in patients with rheumatoid arthritis (RA).Methods Serum levels of RF, ACCP and AKA were examined in 82 RA and 56 non-RA patients and their sensitivity and specificity for the diagnosis of RA were exmined. Statistical analysis was performed to test the association between ACCP/AKA and number of tender joints and swollen joints, ESR, CRP, disease activity score (DAS) or Ritchie's articular index (RAI). Results ROC curve was performed for each single auto-antibody and various combinations of any two of the above antibodies. The area under the ROC curve was over 0.5 (P<0.05). The specificity of ACCP and AKA was 91.1% and 92.9% respectively. RF, ACCP and AKA were all sensitive markers for the diagnosis of RA and the sensitivity could be as high as 95.1% when one of these markers was positive. There were statistical differences in the number of swollen joints, ESR and DAS between ACCP positive group and ACCP negative group (P<0.05) and statistical significant difference was observed in tender joint count, swollen joint count, ESR and DAS between AKA positive and negative groups (P<0.05). Conclusion Combined test of ACCP, RF and AKA is useful in routine RA diagnosis.ACCP and AKA may be clinical markers for predicting disease activity and prognosis.

ObjectiveTo observe the effect of Buzhongyiqi decoction on post stroke fatigue.Methods60 stroke patients with fatigue were given Buzhongyiqi decoction for 4 weeks continuously. Chinese New Drug Clinical Guidelines was to evaluate the effect for patients according to improvement of symptoms.ResultsIn 60 cases, markedly effective in 47 cases (78.33%), effective in 10 patients (16.67%), invalid in 3 cases (5%). Symptoms of malaise, anorexia, muscle soreness were significantly improved.ConclusionBuzhongyiqi decoction can improve post stroke fatigue of stroke patients.

Objective To observe the effects of insulin-like growth factor-2 (IGF2) in the course of mouse embryon-ic stem cells induced to differentiate into islet-like cells. Methods Mouse ES cells were induced to differentiate into islet-like cells in vitro. The expression of islet specific markers was tested by RT-PCR and immunofluorescence assay. RT-PCR/RFLP was used to test the imprinted genes IGF2 parental expression in cells at different stages. Results Islet specific mark-ers were expressed in differentiated cells, such as insulin, glucagon and C-peptide. PCR-RFLP showed that imprinted genes IGF2 derived from embryonic stem cells were biallelic expression and loss of imprinting. Conclusion Gene imprinting sta-tus of IGF2 was changed in differentiated cells in vitro.

Objective To investigate the contribution of Cystatin C to the preoperative diagnosis and clinical therapy of gastroenteric tumor.Methods Using surgical materials from patients with stomach, colon and rectum cancer, immunohistochemisty, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting analysis were performed with antibodies against Cystatin C.Cystatin C of the cancerous and paired noncancerous lesions were determined by enzyme-linked immunosorbent assay (ELISA).Results (1)Immunohistochemical staining of Cystatin C was evident expression in cancer cells and associated stromal tissues, this was not the case in paired noncancerous tissues,there were also statistical relationship between the expression of Cystatin C in cancerous and that in noncancerous tissues (?~2=6.825,P

OBJECTIVE:To ensure a long-term medication in children with asthma,prevent the attack of asthma and ensure safe,effective and correct drug use in these patients.METHODS:The pharmaceutical care for the asthma children was carried out through pharmacists’ involvement in assisting doctors to establish the treatment plan,carrying out medicine-use education and drug use consultation for patients,setting up the medicine-use record and so on.RESULTS & CONCLUSION:The practice of pharmaceutical care can markedly improve the compliance,safety and efficacy of drug use in asthma children as well as improving their quality of life.

Objective:To explore the effect of revision endoscopic sinus surgery (RESS) on quality of life in the patients with chronic rhinosinusitis with nasal polypsis (CRSwNP).Method:To survey and evaluate 60 cases of RESS patiens (treatment group) and 120 normal ones with physical examination (Control group) through the medical outcomes survey short form questions (MOS SF-36) and the Sino-Nasal Outcome Test-20 (SNOT-20), and comparison and analysis of the two groups results which we got were carried out.Result:With SF-36 scales for evaluation of quality of life, the results show that: the scores of CRSwNP patients (treatment group) without surgical treatments with RESS were significantly lower than that of the control group(P<0.05); while use of SNOT-20 scales in evaluation of the properative treatment group patients, the results were significantly higher than that of the control group(P<0.05). While the CRSwNP patients with surgical treatments with RESS for 6 monthes, not only with SF-36 scales but also with SNOT-20 scales,there was no significant difference between the two groups(P>0.05 ).Conclusion:RESS may obviously improve the clinical symptom of CRSNP patients. The SF-36 and SNOT-20 assessment scales could reflect the patient's QoL change.

Objective:To compare the difference of epileptiform discharges detection in patients with epilepsy between the 25 electrodes electroencephalogram (EEG) system proposed by the International Federation of Clinical Neurophysiology in 2017 and the previous 19 electrodes EEG system.Methods:Patients suspected of epilepsy or with confirmed epilepsy who need a follow-up EEG were collected in Zhongshan Hospital, Fudan University from March 2018 to November 2019, and conventional video-EEG recording was performed on all patients for two hours with the standard 25 electrodes EEG system. Two neurophysiologists reviewed the recordings blindly using the 19 electrodes system and the 25 electrodes system, marking the epileptiform discharges and their amplitudes. Finally, the data were statistically analyzed.Results:A total of 403 patients were included in the study, in which 263 cases were diagnosed as epilepsy, including 129 cases of generalized epilepsy, 115 cases of temporal lobe epilepsy, 13 cases of frontal lobe epilepsy, two cases of parietal lobe epilepsy and four cases of occipital lobe epilepsy. In 115 temporal lobe epilepsy patients, 76 (66.09%) and 100 (86.96%) records were detected epileptiform discharges by the 19 or 25 electrodes EEG system respectively, and the difference was statistically significant (χ2=13.939, P<0.001). While in patients with non-temporal lobe epilepsy, there was not statistically significant difference between the two systems. In 76 patients whose temporal epileptiform discharges were detected by the two systems, the amplitudes of epileptiform discharges in the newly-added inferior temporal electrodes (F9/F10, T9/T10, P9/P10) and the original temporal electrodes (F7/F8, T7/T8, P7/P8) were (61.53±22.64) μV and (48.25±20.90) μV, respectively, with statistically significant difference between the two groups ( t=5.486, P<0.001). In patients with abnormal [79.59% (39/49) vs 61.22% (30/49), χ2=3.967, P=0.046] and normal [95.45% (42/44) vs 70.45% (31/44), χ2=9.724, P=0.003] imaging, the ability of the 25 electrodes EEG system to detect epileptiform discharges was higher than that of the 19 electrodes EEG system. Conclusion:The 25 electrodes EEG system can significantly improve the detection ability of temporal epileptiform discharges in patients with epilepsy, which is recommended for regular use to increase the detection ability of temporal area abnormal wave and assist the diagnosis and treatment of epilepsy.

Objective To observe the effects of a decoction of buzhong yiqi in conjunction with rehabilitation training in relieving post-stroke fatigue.Methods A group of 115 stroke patients was enrolled and randomly divided into a simple rehabilitation group and a combination therapy group.Both groups received conventional rehabilitation treatment and appropriate treatment of any primary diseases.In addition,those in the combination therapy group were given a decoction of buzhong yiqi twice daily for a total of 4 weeks.EMG signals,subjective evaluations of fatigue severity,active rehabilitation exercise duration,motor function and ability in the activities of daily living (ADL) were assessed before treatment and after 4 weeks of treatment.The slope of the surface electromyogram's mean power frequency (KMPF) and median frequency (KMF) were used to quantify fatigue.Subjective fatigue severity was estimated using a fatigue severity scale (FSS).The active rehabilitation exercise lasted,on average,90 minutes daily.The Fugl-Meyer assessment (FMA) was used to evaluate motor function and the modified Barthel index (MBI) ADL ability.Results There were no statistically significant differences between the groups before treatment.After 4 weeks of treatment all the outcomes in both groups had improved (except the FSS scores of the simple rehabilitation group).The KMPF,KMF,FSS,exercise duration,FMA scores and MBI scores in the combination therapy group were all significantly better than those in the simple rehabilitation group.Conclusion Taking buzhong yiqi can significantly improve the clinical effects of conventional rehabilitation training on post-stroke fatigue.It helps relieve fatigue,improve active participation in rehabilitation exercise,and also improve motor function and ADL ability.

Objective To evaluate the clinical application of multimodality treatment of brain arteriovenous malformation (BAVM) with Onyx embolization and microsurgery.Methods There were 48 patients with BAVM treated by combination of Onyx embolization and microsurgery.The clinical features,therapeutic process,complications and discharge status (by MRI,DSA and Glasgow outcome scale,GOS) were recorded in detail.The prognosis was estimated by modified Rankin scale (mRS) with 6-42 months' follow-up.Results The total resection rate was 97.9％.The therapy-related complications happened in 8 patients (16.7％).Among them,4 cases had dysfunction of central nervous system (8.3％),2 cases with intra-cerebral hemorrhage (4.2％),and 2 suffered from severe cerebral edema (4.2％).Good recovery was seen in 38 cases (79.2％) evaluated by GOS when discharged from hospital.The follow-up result mRS ＜ 3 was 97.9％.Conclusion Multimodality treatment of BAVM with Onyx embolization and microsurgery should be a good therapeutic strategy.