Objective To compare the medical expenditure and its trend for diabetes mellitus and non-diabetes mellitus and to assess the direct economic burden of diabetes for individuals and families.Methods Using data from the China Health and Nutrition Survey (CHNS),propensity scores matching (PSM) was used to match diabetes mellitus and non-diabetes mellitus according to the related characteristic variables.Data from 679 pairs of objects was then compared.Results From 2000 to 2009,gaps of annual medical expenditure from diabetes mellitus and non-diabetes mellitus showed an increase,from 3361.93 to 6608.48 Yuan,with the ratios of medical expenditure about 4 times.The ratios of personal economic burden and family economic burden had an increase of about 4-5 times.Conclusion Compared with non-diabetes mellitus,the annual medical expenses was significantly higher among patients with diabetes mellitus.The absolute cost appeared a dramatic increase,along with the personal and familiar economic burden.

OBJECTIVEThe aim of this paper was to investigate the factors associated with viral response and HBeAg seroconversion and the relationship between them at different stages of interferon treatment in HBeAg-positive chronic hepatitis B patients.

METHODSPEG-IFN alfa-2a was injected subcutaneously in doses of 180 microg once a week for 48 weeks to HBeAg-positive chronic hepatitis B patients, and the patients were followed for another 24 weeks after the treatment. The serum HBV DNA load was measured by real-time quantitative PCR assay. Microparticle enzyme immunoassay analysis (MEIA) was then carried out by an automatic enzyme immunoassay analysis instrument to measure HBeAg and anti-HBe. Virological response and HBeAg seroconversion rates, and the factors associated with them were analyzed.

RESULTSThe differences in ALT baselines between viral responding and non-responding groups were significant at treatment time and at the end of the follow-up period. These differences were also significant in patients with HBeAg seroconversion at 12 weeks and at the end of the follow-up period compared with the non-conversion group. No significant difference of HBV DNA baseline was observed between the HBeAg seroconversion and non-conversion group. At 12, 24 and 48 weeks, in patients with viral response during the treatment, their HBeAg seroconversion rates were 43.8%, 21.4% and 18.9% respectively; their respective HBeAg seroconversion rates remaining at 72 weeks were 42.9%, 33.3% and 27.6%. HBeAg seroconversion was related to HBV DNA negativity at 48 weeks treatment in the multivariate analysis (OR=2.15, 95.0% CI=1.744-2.664, P less than 0.01).

CONCLUSIONSViral response and early and sustained HBeAg seroconversion were associated with pretreatment ALT levels. HBeAg seroconversion was related to viral response during IFN treatment, but not to the baseline HBV DNA load.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; drug effects ; Hepatitis B, Chronic ; blood ; drug therapy ; virology ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Middle Aged ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; Young Adult

Objective?To explore the effects of early cold compress post injury and operation for patients with ankle peripheral fracture. Methods?From January 2015 to January 2016, we selected 152 selective operation patients with ankle peripheral fracture from Xi'an Honghui Hospital, the Affiliated Hospital of Xi'an Jiaotong University. All of the patients were randomly divided into control group and observation group, 76 cases in each group. Patients of observation group accepted continuous cold compress around ankle and routine orthopaedics treatment post injury and 24 hours after operation. Patients of control group were treated with routine orthopaedics treatment. We compared the degree of swelling, Face Rating Scale (FRS), hospital days, incidence of tension blister and the score of ankle hindfoot scale of American Orthopaedic Foot & Ankle Society (AOFAS) of patients between two groups after injury and operation. Results?The added value of limb circumference of patients of observation group one day before surgery and the third day after surgery was (17.1±5.7) mm and (14.1±5.9) mm respectively lower than those of control group (t=8.566, 5.065; P＜0.01). The score of FRS the first after surgery was (2.8±0.9) in observation group and (3.3±1.1) in control group with a significant difference (t=3.067, P＜ 0.01). There were three patients with tension blister in observation group and 13 patients in control group with a significant difference (χ2=6.985, P＜0.01). The difference in hospital days between observation group [(6.8±1.3) days]and control group [(8.9±2.6) days]was significant (t=6.298, P＜0.01). There was a significant difference in the score of ankle hindfoot scale of AOFAS three months after surgery between observation group (80.5±15.1) and control group (74.2±11.8) (t=2.866, P＜ 0.01). Conclusions?The early cold compress post ankle peripheral fracture and operation has advantages in reducing fracture and surgery injury complications, shortening average hospital stay, speeding up postoperative rehabilitation and so on. It is the practical application of fast track surgery in nursing of traumatology orthopaedics.

Objective To investigate the effects of the order of individual liquid on the survival of skin flap in patients after free flap transplantation .Methods From March 2013 to March 2016, 102 patients with trauma in extremities and underwent free flap transplanation in our hospital were randomly assigned to the study groupand the control group , with 51 cases in each group .Patients in the study group were treated with adjusted liquid order according to physiological and biochemical indexes .Patients in the control group were treated according to the order of medical orders .The occurrence of vascular crisis 48 h after operation and flap necrosis that 10 days after free flap transplantation were compared .Results 48 h after operation , there were 6 cases of postoperative vessel thrombosis and 3 cases of necrosis in the study group (χ2=5.795,P<0.05).10 d after operation , there were 11 cases of postoperative vessel thrombosis and 3 cases of necrosis in the control group (χ2=5.299,P<0.05).Conclusions The individualized order liquid infusion can effectively reduce the occurance rate of vascular crisis and necrosis after free flap transplantation .

Goiter is a kind of non-inflammatory and non-neoplastic hyperplasia and enlargement. Many studies have shown that substances such as thiocyanates and isothiocyanates can prevent the development of a variety of tumors. However, some studies have also found that such substances can lead to goiter. In this article, relevant information on common goitrogen in food are collected to explore their mechanism of action, laying a foundation for guiding residents to maintain a healthy and balanced diet.

This study is to investigate the protective effects of the SB203580 against radiation induced mortality and intestinal injury of mice. A total of 67 male C57BL/6 mice (20.0-22.0 g) were matched according to body weight and randomly assigned to one of three groups: control, total body irradiation exposure (IR, 7.2 Gy) only, and IR (7.2 Gy) + SB203580 (15 mg x kg(-1)). 30 days survival rate was observed in the experiment. In intestinal injury experiment, the expression levels of caspase-3, Ki67, p53 and p-p38 were assayed in the mice intestine crypts. The results showed that the 30 days survival rate was 100% (control), 0 (IR) and 40% (IR+ SB203580), separately. Compared to the IR groups, the positive cells of caspase-3, p53 and p-p38 in crypt cells decreased 33.00%, 21.78% and 34.63%, respectively. The rate of positive cells of Ki67 increased 37.96%. Significant difference was found between all of them (P < 0.01). SB203580 potently protected against radiation-induced lethal and intestinal injury in mice, and it may be a potential radio protector.
Animals ; Apoptosis ; radiation effects ; Caspase 3 ; metabolism ; Enzyme Inhibitors ; pharmacology ; Imidazoles ; pharmacology ; Intestines ; drug effects ; metabolism ; pathology ; Ki-67 Antigen ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Pyridines ; pharmacology ; Radiation Injuries, Experimental ; metabolism ; mortality ; pathology ; Radiation-Protective Agents ; pharmacology ; Random Allocation ; Tumor Suppressor Protein p53 ; metabolism ; Whole-Body Irradiation ; p38 Mitogen-Activated Protein Kinases ; metabolism

Objective: To assess the significance of DDAVP use in the diagnosis and treatment of VWD. Methods: An analysis of 15 VWD cases who referred to Hematology Division of First affiliated Hospital of Soochow University and treated with DDAVP from March 2016 to August 2018 was conducted. Efficacy and treatment response of DDAVP were monitored by observations of changes in factor Ⅷ procoagulant (FⅧ∶C) and von Willebrand Factor (VWF) related indicators before and 2 h after DDAVP injection. Results: Of 15 cases with VWD, 7 males and 8 females with a median age of 23 (6-46) years, 7 of 9 type I VWD patients achieved complete response (CR) , 1 type 2A VWD case CR, 5 type 3 VWD ones no response (NR) . The VWF multimer analysis in 5 patients combined with other plasma VWF values were in accordance with the known diagnosis. Conclusions: DDAVP was effective in most type 1 patients, and ineffective in some type 2 and almost all type 3 cases. It was helpful for diagnosis and subsequent treatment planning.
Adolescent ; Adult ; Child ; Deamino Arginine Vasopressin ; Female ; Hemostatics ; Humans ; Male ; Middle Aged ; Young Adult ; von Willebrand Diseases ; von Willebrand Factor

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Angiogenesis inhibitors targeting the VEGF signaling pathway are developed into drugs for the treatment of vaious diseases, such as cancer, rheumatoid arthritis, and age-related macular degeneration. Recent studies have revealed that oleanolic acid (OA), a natural pentacyclic triterpenoid, inhibited the VEGF/VEGFR2 signaling pathway and angiogenesis in HUVECs, which may represent an attractive VEGF inhibitor. In this paper, rational structural modification towards OA was performed in order to improve its inhibitory effects aganist VEGF and anti-angiogenesis potential. As a result, a series of novel OA derivatives, possessing α,β-unsaturated ketone system in ring A and amide functional group at C-28, were prepared and evaluated for cytotoxicity and their ability to inhibit VEGF-induced abnormal proliferation of HUVECs. The results showed that two promising derivatives, OA-1 and OA-16, exhibited no in vitro cytotoxicity against HUVECs but showed more potent inhibitory activity against VEGF-induced proliferation and angiogenesis in HUVECs, compared with OA. The results of Western blot indicated that OA-1 and OA-16 inhibited VEGF-induced VEGFR2 activation. Furthermore, small interfering RNA experiments were performed to confirm that both compounds inhibited VEGF-induced angiogenesis via VEGFR2. Thus, the present study resulted in the discovery of new promising OA-inspired VEGF inhibitors, which can serve as potential lead compounds for the treatment of angiogenesis-related diseases.
Cell Movement ; Cell Proliferation ; Human Umbilical Vein Endothelial Cells ; Humans ; Oleanolic Acid/pharmacology* ; Vascular Endothelial Growth Factor A/metabolism*

The Ministry of Education and other four departments jointly issued the Notice on the Construction of high-level schools of public Health, proposing that "it will take ten years to build a number of high-level schools of public health, and form a high-quality education development system to adapt to the construction of modern public health system". At present, the construction of high-level public health schools in various universities in China is in full swing. The high-level School of Public Health and the CDC have played an important role in constructing the national public health system and the human health community. The high-level public health schools are of strategic significance and important value to the development of the CDC. The review presents reflections and insights on the role of high-level public health schools in the development of the CDC and the challenges they might face.
Humans ; United States ; Schools, Public Health ; Schools ; Universities ; Public Health ; Centers for Disease Control and Prevention, U.S.