OBJECTIVE:To provide reference for investigating the disease burden of diabetic patients and promoting rational drug use. METHODS:Open-ended questionnaires were adopted to survey the willingness to pay(WTP)of some diabetic patients in Sichuan Provincial People’s Hospital and collect the data about personal information,health status,the affordability of disease and WTP,the data was sorted with Excel (version 2013) software by two operators and analyzed with SPSS 17.0 software by step-wise multiple linear regression to explore the influential factors of WTP values. RESULTS:Totally 120 questionnaires were sent out and 106 were effectively received with effective rate of 88.3%. The average age of respondents was (59.9 ± 13.9) years old,the average body mass index (BMI) of respondents was (24.5 ± 0.5) kg/m2,the highest proportion of monthly diabetes fees was no more than 300 yuan,followed by more than 300-500 yuan and more than 500-1 000 yuan;the awareness rates of fasting plasma glucose (FPG),2 h postprandial blood glucose (2 h PG) and glycated hemoglobin (HbA1c) were 95.3%,86.8% and 68.9%,respectively;and patients with more than 2 complications accounted for 29.5%. The WTP values of respondents to the complete recovery of HbA1c,FPG and 2 h PG were 1 604.1,1 617.9 and 1 683.7 yuan/month,the median values were 1 000 yuan/month;the WTP values of respondents to the 10% recovery were 867.4,908.5 and 877.9 yuan/month,the median values were 500,575 and 510 yuan/month,respectively. The influential factors with positive effects and significant differences on WTP values in step-wise multiple linear regression were total annual household income,complications,hospital experience,family history of di-abetes,diabetes mental status and cost of diabetes in the past months;those with negative effects and significant differences on WTP values were age,FPG level and education level. CONCLUSIONS:Diabetic patients,particularly,with peripheral neuropa-thy,high blood lipids or diabetic foot have higher WTP value,which shows they hole heavier mental burden and disease burden than others. Patients recovered 10% percent were closer to actual treatment state,which better show the influential factors of WTP values actually,and patients with a family history of diabetes,depressed mood,higher fees in the average monthly cost,and hospi-tal patients have higher WTP values.

Objective To investigate the protective effect of c-jun N-terminal kinase (JNK)inhibitor SP600125 against acute liver failure in mice.Methods Fifty-five male C57/BL6 mice were divided into control group (n =30) and SP600125 group (n =25).The animals were given an intraperitoneal injection of D-galactosamine (D-GalN,400 mg/kg body weight)/lipopolysaccharide (LPS,30 μg/kg body weight).The control group and SP600125 group were given 10％ dimethyl sulfoxide (15 mL/kg body weight) or SP600125 (75 mg/kg body weight) subcutaneously 12 h and 1 h before D-GalN/LPS administration,respectively.D GalN/LPS induced mouse JNK activation was detected by immunohistochemistry for phospho JNK (p-JNK).D-GalN/LPS induced mouse liver cell apoptosis was detected by immunohistochemistry for Caspase-3 and TdT-mediated-dUTP nick endlabeling (TUNEL).Serum alanine transaminase (ALT) level was tested to assess liver injury.Survival rate of mice within 24 h after D-GalN/LPS administration was observed.The comparison between groups was done by t test and survival rate was analyzed by Kaplan-Meier method.Results JNK activity in liver tissues,as indicated by observation of p-JNK positive cells by immunohistochemistry,was diminished 4 h after D-GalN/LPS administration in SP600125 group.Reduced Caspase-3 activity was observed 6 h after D-GalN/LPS administration in SP600125 group (as indicated in immunohistochemistry by Caspase-3 positive cells).Mice in SP600125 group showed significantly lower TUNEL-positive cell count than control group (43.0±24.5 vs 194.7±73.8; t=9.743,P=0.000).Serum ALT level 6 h after D-GalN/LPS administration was (24.0±54.7) U/L in SP600125 group,which was significantly lower than that in control group [(1234.4±478.4) U/L; t=4.734,P=0.0015].SP600125 also significantly improved the survival rate within 24 h after D-GalN/LPS administration (4/5 vs 1/10； x2=5.225,P=0.0223).Conclusions JNK inhibitor SP600125 exerts protective effects against D-GalN/LPS induced acute liver failure in mice by suppressing JNK activation and hepatocyte apoptosis.

Objective To evaluate the application value of DNA ploidy detection using flow cytometry method(FCM)in malignant tumor identifi?cation,so as to provide the theoretical basis for the clinical diagnosis of malignant tumors. Methods Two researchers finished the literature screen?ing independently,and all the literatures were given the secondary screening according to the inclusion and exclusion criteria. The included literature data was analyzed by Meta?DiSc 1.4,including heterogeneity test,sensitivity,specificity,diagnostic odds ratio(DOR)and summary receiver operat?ing characteristic(SROC)etc. Results Totally 12 literatures were included in the study finally,including a total of 1 340 subjects consisting of 516 cases with malignant tumor and 824 cases with benign tumor. Heterogeneity inspection results showed that the Spearman correlation coefficient of sensitivity logarithm and(1-specificity)logarithm was-0.343 and there was no threshold effect(P=0.275). DOR curves was Cochran?Q=26.49 (P=0.005 5),indicating the heterogeneity was caused by non threshold effects. Combined statistical quantity was calculated with a random effects model and the results were as followings:the sensitivity was 0.72(95%CI:0.68?0.76,I2=50.1%)and the specificity 0.84(95%CI:0.81?0.86,I2=65.5%). SROC curve drawing,DNA ploidy detection of benign and malignant tumors showed AUC=0.845 3 and Q*=0.776 8. Conclusion FCM DNA heteroploid has a high accuracy for diagnosis of malignant tumor,which can be an important supporting means for the discrimination between benign and malignant tumor.

BACKGROUND: Compression occurs in several horizontal spinal cords of patients with multilevel cervical spondylotic myelopathy (CSM), especially compression is attacked on both ends of spinal cord. Therefore, there are so many choices of approach and way for operation. However, which approach and way have good effects and few complications is still controversial up to now.OBJECTIVE: To observe the therapeutic effect of anterior multilevel decompression and internal fixation on multilevel CSM and compare with posterior mono-open-door vertebral canal expanding laminoplasty.DESIGN: Contrast analysis.SETTING: Department of Orthopaedics, Xiangya Hospital of South China University; Department of Orthopaedics, People's Hospital of Liuzhou.PARTICIPANTS: A total of 68 patients with multilevel CSM were selected from the Department of Orthopaedics, Xiangya Hospital of South China University from January 2000 to June 2005. All patients were divided into anterior approach surgery group (n =33) and posterior approach surgery group (n =35). Baseline data between the two groups were comparable.METHODS:①Anterior approach surgery group: All 33 patients received bone-transplanting and internal fixation through cervical spine. Among them, auto-iliac bone-graft was transplanted into 17 cases, Cage auto-bone graft combining with allogenic bone was transplanted into 11 cases, and titan-net and auto-bone combining with allogenic bone was transplanted into 5 cases. In addition, long segments were dealt with internal fixation of anterior cervical spine locking plate (CSLP). Among them, 12 cases used Orion plate, 13 cased used Zephir palte, and 8 cases used Codman plate. ②Posterior approach surgery group: Fifteen patients received total laminectomy for decompression and other twenty patients received mono-open-door vertebral canal expanding laminoplasty. After laminoplasty, all patients received negative pressure and neck support fixation for three months.MAIN OUTCOME MEASURES: ①Scores were measured based on JOA evaluating system before and after laminoplasty to calculate recovery rate. The scores of JOA ranged from 0 to 17. The higher the scores were, the milder the spinal cord damage was. ② Magnetic resonance image (MRI) was used to measure and calculate the sagittal diameter of dural sac.RESULTS: A total of 68 patients were involved in the final analysis. ①Mean operative time and bleeding volume were respectively shorter and less in the posterior approach surgery group than those in the anterior approach surgery group (P＜0.05). ②Recovery rates were higher in the anterior approach surgery group than those in the posterior approach surgery group [(58.28±7.16)%, (42.71±5.85)%; (45.64±6.56)%, (37.65±5.75)%; P＜0.05].③Follow up lasted for more than 6 months. Fusion rate in the anterior approach surgery group was 100%, and mean fusion time was 4.6 months. Mobilization and breakage of plate and screw were not observed during the laminectomy.CONCLUSION: The posterior approach surgery is simple and spends a short-term duration, but the effect of posterior approach surgery is inferior to anterior approach decompression.

Objective To investigate the repair function of extracorporeal membrane oxygenation (ECMO) in vivo for the liver after cardiac death with warm ischemia injury for 30 min from cardiac death swinc.Method Ten landraces,30 to 40 kg,randomized to experimental group and control group,were used to make 30-min cardiac death models through clamping trachea after deep anesthesia.An intravenous cannula was placed through right iliac arteries and veins,and connected to ECMO extracorporeal circulation pipes in experimental group.The balloon catheter was placed to diaphragm plane through left femoral artery.The ECMO was performed to infuse abdominal organs,and pH and electrolyte were adjusted.The circulation flow rate,intraperitoneal organ perfusion pressure,venous blood gas,electrolyte,transaminase,and bile product,etc.were monitored and recorded.The livers of control group were retrieved after 30-min cardiac arrest and stored in cold UW for 4 h.Pathological tissue was sliced and stained by HE.Result After 30-min cardiac arrest,the liver showed obvious congestion appearance; pathologically,there were hepatic sinus expansion,blood cells clog,and erythrocyte aggregation.Circulating blood gas analysis revealed severe acidosis.After the ECMO recirculation started,circulation flow rate maintained to 1 L/min,the liver gradually restored bright red,pathological biopsy showed that hepatic sinus expansion disappeared,and clogged blood cells dispelled.AST was markedly increased to (226.0 ± 28.0) U/L after 30-min cardiac arrest and reduced to (150.0 ± 30.0) U/L 4 h after the ECMO recirculation.Average bile production was 7.75 ml/h.Conclusion ECMO recirculation in vivo can repair the injured livers from cardiac death donor with 30-min cardiac arrest.

Objective To study the characteristics of susceptibility weighted imaging (SWI) and it's role in glioma classfication. Methods 45 glioma patients with pathologically confirmion, underwent preopera-tive plain MRI, enhanced MRI and SWI examination. By using double blind method, the score of T1 WI, T2WI, enhanced T1 WI, SWI and enhanced SWI were acquired to display enhancing tumor, peritumoral edema, tumor hemorrhage and tumor vein. The tumor volume of low signal areas was measured by using measurement software to acquire the bleeding of tumor. Results In 26 cases of high grade gliomas,18 patients with intratu-moral, multiple patchy low signal cords in varying degrees, which were proved by pathology as tumor hemorrhage and tumor blood vessels; in 19 case of low grade gliomas, 10 cases occured a few spots, linear low signal in tumor, which were proved by pathology as tumor hemorrhage; the bleeding of high grade gliomas was higher than that of the low level group ( P < 0.05 ). SWI was superior to T, WI, T2 WI on displaying tumor hemorrhage and tumor vein(P<0. 05). Conclusion Different grades of glioma show obvious different display on SWI, and SWI probably be helpful for evaluation of glioma grading preoperatively.

China ; epidemiology ; Humans ; Pneumoconiosis ; epidemiology

The inhibitory effects of Endostar in combination with radiotherapy in BALB/c nude mice model of human CNE2 nasopharyngeal carcinoma and the mechanism were investigated. In nude mice model of CNE2 nasopharyngeal carcinoma, the inhibitory rate and the sensitizing enhancement ratio (E/O) were calculated according to the tumor volumes in different groups. The expression of microvascular density (MVD) in tumor tissues was examined by using immunohistochemistry staining. The transcription of VEGF gene was detected by using RT-PCR. The inhibitory rate in Endostar+ radiotherapy group was higher than in other groups. In Endostar+radiotherapy group, the tumor volume was significantly decreased and the E/O ratio was 2.335, suggesting that Endostar could be a radiosensitizer. The expression of MVD of tumor tissues in Endostar+radiotherapy group was reduced significantly. The expression of the MVD in treatment groups was significantly different from that in control group (P<0.05). Compared to other groups, VEGF mRNA expression in Endostar+radiotherapy group was decreased remarkably. Endostar in combination with radiotherapy significantly inhibited the growth of CNE2 tumor. The combination therapy decreased the expression of VEGF, and inhibited tumor angiogenesis and proliferation. When combined with radiotherapy, Endostar acted as a radiosensitizer.

To test the hypothesis that the controlled reperfusion of warm blood cardioplegiacontaining mannitol would result in more effectively improved recovery of myocardial function by prevent-ing or reducing a potentially harmful component of reperfusion. Methods: Thirty-two cats were divided in-to four groups. Group Ⅰwas not subjected to ischemia or reperfusion injury. Group Ⅱ was subjected to60 min hypothermic ischemia. Group Ⅲwas subjected to 60 min hypothermic ischemia and 60 min reperfu-sion. Group Ⅳ was controlled reperfusion with warm blood cardioplegia containing mannitol. Results:Myocardial functlon was significantly depressed after 60 min reperfusion- Increased myocardial water con-tent and low ATP c0ntent were observed also. Controlled reperfusion with warm bl0od cardioplegia con-taining mannitol was helpful to improve the recovery of myocardial function and ATP content, and to re-duce the myocardial water content. Conclusion: These results indicate that controlled reperfusion after is-chemia provides benefit in avoiding myocardium from reperfusion injury.

Objective To investigate the effects of mirror visual feedback (MVF) and electromyographic biofeedback (EMGBF) on upper extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group (n=30), EMGBF group (n=30) and MVF group (n=30). All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addition. They were assessed with Fugl-Meyer Assessment (FMA) and the Upper Extremity Function Test (UEFT), and their integrated electromyogram (iEMG) of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the iEMG after treatment (P<0.05), and ranked as the MVF group, the EMGBF group and the control group from improving more to less (P<0.05). Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.