Objective:To figure out the characteristics of annual medical expenditure for rural residents and its distribution among different population.Methods:The individual annual medical service utilization information was summarized after dealing with the database of the 2014 new rural cooperative medical system by Excel.It prescribed the clustering of medical expenditure by Lorenz curve and Gini index.Descriptive statistics and x2 test were used to compare the characteristics and distribution of the annual medical expenditure among rural residents.The Chi-square test was conducted to compare the differences of the population distribution.Results:The costliest 5％ patients accounted for approximately 68％ of total health care expenditure.The annual total expenditure was 16628 yuan per capita among high-cost population,while low-cost population were 108 yuan.The Gini index of medical expenditure for rural residents was 0.81.Among female and population over 45 years old,the proportion of high-cost population was higher than 5％.People living near provincial road,in flatlands or areas where the ability of township hospital was limited were nore likely to expense higher medical costs,known as 6.40％,5.50％ and 5.80％ separately.Conclusion:Clustering of medical expenditure for rural residents was remarkable,while the expenditure among high-cost,medium-cost and low-cost population were quite different.The elderly,female and primary population living in areas where the ability of township hospitals were limited were more likely to generate high medical costs.

As a high sensitive biomarker of lung cancer ,IGFBP2 plays an important role in the occur-rence,development and treatment of lung cancer .Studies have showed that it promotes tumor progression by acti-vating the IGF1R and integrin mediated signal transduction pathway .Recent researches have demonstrated that it participates in targeted therapy of lung cancer ,which may become a new target for the treatment of lung cancer . This paper makes a review on the relationship between IGFBP 2 and lung cancer .

Fatal Outcome ; Female ; Humans ; Infant ; Mucocutaneous Lymph Node Syndrome ; mortality ; therapy

Objective To explore the effect of action research based on group learning in hospice care module for nursing students. Methods 82 students were divided into cooperative learning group (40) and conventional teaching group (42). The cognition and attitude of good death questionnaire was used to evaluate teaching effect before and after teaching of hospice care. After teaching, self-feedback and self-feedback questionnaire were made to evaluate the effect of cooperative learning group. SPSS 17 was used to make comparison of data between groups and within groups, and t test, chi square test or Fisher exact probability 2 were also used . Results There were no difference between two groups of nurses before teaching. The students' cognitive level and attitude in cooperative learning group increased significantly, especially their cognitive level of physiological needs (t=5.398, P=0.001), cognition and attitude of death education in intervention group was higher than control group (t=2.992, P=0.004; t=3.661, P=0.001). Although 95% of the nursing students of the cooperative learning group thought group cooperative studying could improve their interests and cultivated their comprehensive abilities, only 50% could accept this kind of studying methods . Conclusions Action research based on group cooperative studying can improve students' cognitive level and attitude of good death, and it is also good for cultivating their ability of au-tonomous learning, innovation, cooperation, and meanwhile, educational action research is a good way to improve both teaching effect and research ability of teacher staffs, but in practice, students' acceptance of group learning needs to be improved.

Adolescent ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; blood ; drug therapy ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Infant ; Interleukin-23 ; blood ; Male

Objective To investigate the correlation between the level of serum cortisol and alexithymia in depressive patients with somatic symptoms.Methods The morning level of serum cortisol was measured with radioimmunoassay in 30 depressive patients with somatic symptoms (somatization group) and 30 depressive patients without somatic symptoms (non-somatization group).The severity of alexithymia was evaluated with Toronto alexithymia Scale(TAS-20).Results (1) The level of serum cortisol in somatization group was significantly higher than that in non-somatization group((533.88±144.10) μmol/L vs (458.27±82.87) μmol/L,P＜0.01).(2) The total TAS score and the factor score of Difficulty in identifying feelings and Difficulty in describing feelings in somatization group were obviously higher than those in non-somatization group,respectively ((67.13 ± 6.96) vs (62.03±7.14),(24.50±3.78) vs (21.63±3.63),(15.30±2.69) vs (13.57±2.03),all P＜0.01).(3) The level of serum cortisol in somatization group was positively correlated with the total score of alexithymia (r=0.596,P＜0.01) and the factor score of Difficulty in identifying feelings, Difficulty in describing feelings, externally oriented thinking,respectively (r=0.391,0.435,0.452,all P＜0.05).(4) The level of serum cortisol in non-somatization group was positively related to the total TAS score (r=0.418,P＜0.05) and the factor score of externally oriented thinking(r=0.489,P＜0.01).Conclusions Compared with depressive patients without somatic symptoms,depressive patients with somatic symptoms had more severe alexithymia,especially in Difficulty in identifying feelings and Difficulty in describing feelings.The severity of alexithymia was positively correlated with the level of serum cortisol.

Objective To evaluate and demonstrate ultrasonographic characteristics of mandibular ameloblastoma with active proliferation. Methods Nineteen subjects with ameloblastomas in the mandibles were examined with ultrasonography. In addition to sizes,internal echoes,the research was focused on blood flow of the tumors and destruction of mandibles. Ultrasonographic appearances of the tumors were compared with histopathological findings. Sensitivity and specificity of Doppler flow signals and destruction of mandibles for prediction of active tumor proliferations were calculated. Results Fifteen cases (79%)showed no or minimal flow signals on color Doppler flow imaging(CDFI), whereas the remaining 4 lesions demonstrated abundant flow signals,in which 3 cases were confirmed histopathologically with active tumor proliferations. The sensitivity and specificity of the Doppler flow signals for prediction of active tumor proliferations were 100% and 94%, respectively. Fourteen cases (74%) showed the mandibular cortices were thin but continuous,among the remaining 5 lesions showed local cortices destruction,3 of them were confirmed histopathologically with active proliferations. The sensitivity and specificity of the destruction of cortical bone for prediction of active tumor proliferations were 100% and 88 %, respectively. Conclusions Ultrasonography can be used as a new effective supplementary diagnostic method for mandibular ameloblastomas. CDFI of tumor vascularity and destruction of cortical bone could be used to predict active tumor proliferations and invasiveness.

Objective To learn the suitability and validity of readmission service at counties and townships in rural China.Methods Seven pilot counties were randomly selected from the eastern,middle and western areas of China,and five diseases of the respiratory infection and cerebral system were set as the targets,while 600 target inpatient readmitted who had any of the five target diseases from 2012 to 2013 in such counties were selected from the NRCMS database.With expert consultation and empirical evaluation,the fitness of the days of stay at township hospital and necessity of hospitalization at county hospitals were evaluated for such target inpatients.Results 64.7％ of the target inpatients were found with unfit days of stay at township hospitals,mostly too short;59.0％ of the target inpatients' hospitalization at county hospitals were found with serious risk factors during their hospitalization;18.5％ of the inpatients were found with unnecessary hospitalization.Conclusions Hierarchical medical system can enhance the efficiency of the heahhcare system,but the current validity of readmission is poor,so is the fitness of days of stay at township hospitals,and the quality of the referral pattern.These problems mostly result from poor medical competence at township hospitals and high autonomy of patients in seeking medical service anywhere in the country.

Through the investigation of Phellodendron Cortex on the market, and 28 batches of samples were collected. By using spectrophotometer the color values of outer surface, inner surface and cross - section of these samples were measured. These measured color data was translated into 3D structure diagram by using the Lab color space tool. The level difference value, the mean value and the threshold value were calculated based the measured color data of these different batches of samples. All 28 groups measured data was analyzed using the methods of Ward linkage and average Euclidean distance. At the same time, we invited Professor Jin Shiyuan, the "Chinese medicine master", to identify, quality-evaluate and grade these 28 batches of Phellodendron Cortex samples base on the traditional experience, then compared the traditional empirical results with the spectrophotometer measurement results. The result showed that, the Phellodendron Cortex could be divided into Phellodendri Amurensis Cortex and Phellodendri Chinensis Cortex by color numerical clustering, and classified according to quality. The classification result has a high degree of consistency with the traditional experience.
China ; Color ; Herbal Medicine ; economics ; Phellodendron ; chemistry ; classification ; Plants, Medicinal ; chemistry ; classification ; Quality Control ; Spectrophotometry

ObjectiveTo evaluate the short-term effectiveness of tension-free vaginal tapeobturator system(TVT-O) on the type Ⅰ,Ⅱ stress urinary incontinence(SUI) in the elderly female patients. Methods Elderly female patients (73 cases) with SUI type Ⅰ and Ⅱ were selected in 0.5-3.0 years after TVT-O surgical treatment,and they reached the age over 60 years before TVT-O.Difference of daily life and lower urinary tract symptoms before and after surgery were compared by the incontinence impact questionnaire ( Ⅱ Q-7) and the urogenital distress inventory (UDI-6) through telephone survey.Results Totally 73 patients were followed up successfully,aged 60 to 72 years (mean 64.0±4.5).Preoperative patients' daily life quality such as making housework,activities,entertainment,go-out,social contact and emotion had obviously been affected with a score of 9 to 25 by their own scoring (mean 17.0±6.7).Lower urinary tract symptoms including urgency,frequent urination,movement,leakage of urine volume,odynuria and dysuria were from 8 to 21 (mean 14.0±4.7) scores.Mild urinary frequency was 8.2％ (6 cases).Urinal pad usage was in 71 cases (97.3％)After TVT-O,patients' symptoms improved by their own scoring.The Ⅱ Q-7 scores were ranging from 2 to 13 (mean 6.4±3.2),and lower urinary tract symptoms scores from 1 to 9 (mean 5.4±3.2).Mild urinary frequency after surgery was 1.4 ％ (1 case).The urinary incontinence in 39 cases completely disappeared (53.4 ％ ),urinal pad usage were in 34 cases (46.6 ％ ).18 cases (24.7 ％ ) had suprapubic area pain or discomfort postoperatively.Conclusions TVT-O is an ideal choice for type Ⅰ and Ⅱ SUI in elderly female patients.