Although the Shanghai's basic health insurance always takes the leading position nationwide in the aspects of coverage, funding level, security level, etc, it still cannot avoid the contradictory problems brought by the rapidly rising demand for health care, poor results of funds management, etc. Commercial health insurance has its u-nique advantages in terms of funds and personnel management. Therefore, they can play their complementary role to the basic medical insurance in order to improve the basic health insurance system. Based on the perspective of com-mercial health insurances, this paper explores the basic health insurance system in Shanghai from the aspects of man-agement patterns, governing body, insurance objects, funding modalities and insurance programs.

PurposeTo investigate whole-body magnetic resonance imaging in diagnosis of idiopathic inflammatory myopathy (IIM), and to guide clinical treatment.Materials and Methods Twenty-six patients clinically diagnosed IIM including 19 dermatomyositis and 7 polymyositis were analyzed retrospectively. Whole-body MRI was performed in all patients including whole-body coronal scan and axial scan of both sides of thigh. Short tau inversion recovery (STIR) sequences were used in the coronal scan and T1WI and fat-suppressed T2WI were performed in the axial scan. Ten healthy volunteers were recruited as control group. MRI findings were compared between the two groups.Results Whole body MRI showed that muscles were homogeneously low signal intensity in the control group. Imaging findings of the patients with IIM included muscle inflammation, fascitis, subcutaneous tissue edema, muscle atrophy and fatty infiltration. The most common distribution site of muscle inflammation of dermatomyositis patients was thigh (n=18), followed by gluteus (n=14), great psoas muscle (n=13), shoulder muscles (n=11), leg muscle (n=11), erector spinae (n=10) and neck muscles (n=9). Findings out of muscles included cavities in the both lungs, infarction in femurs and tibias, avascular necrosis of femoral head, adrenal mass and thyroid nodules. The most common distribution site of muscle inflammation of polymyositis was thigh (n=5), followed by gluteus (n=3), great psoas muscle (n=3), shoulder muscles (n=2), leg muscles (n=2), erector spinae (n=1) and neck muscles (n=1). Findings out of muscles included 1 case of infarction in femurs and tibias.Conclusion Whole-body MRI can not only comprehensively evaluate the activity of IIM but also detect complications such as bone infarction. It's a powerful tool for diagnosis, guiding treatment and monitoring of IIM.

Background:Bioinformatics is an effective technology for microarray data mining and gene function prediction. Aims:To analyze the gene CRELD2 that associated with pathogenesis,disease activity and efficacy of biological agents in ulcerative colitis( UC)by bioinformatics to provide a theoretical basis for subsequent studies on its biological function and molecular mechanism in the development and progress of UC. Methods:The microarray data associated with pathogenesis, disease activity and efficacy of biological agents in UC were downloaded from the Gene Expression Omnibus( GEO database);the data mining and analyses were conducted by using bioinformatics tools such as BRB-ArrayTools, ProtParam,ELM,SignalP 4. 1,PBIL-IBCP Lyon Gerland,GO and STRING. Results:Cross-over analyses revealed that expressions of four genes(CDC25B,CRELD2,IL1RN,PITPNC1)were up-regulated in the order from colonic mucosa of healthy subjects,un-inflamed mucosa of active UC patients to inflamed mucosa of active UC patients,meanwhile these four genes were significantly down-regulated in infliximab responders after treatment when compared with that before treatment and infliximab non-responders. The function of CRELD2 gene was unknown. Bioinformatics analyses showed that CRELD2 gene was located on the long arm of chromosome 22(22q13. 33),and encoded a secreted protein composed of 402 amino acids. This protein contained several epidermal growth factor( EGF)-like domains,mainly distributed in Golgi apparatus, endoplasmic reticulum and extracellular site and had calcium- and protein-binding effect. Interactions existed between CRELD2 and CHRNA4,CHRNB2 and RHBDD3 proteins. Conclusions:Gene CRELD2 may have EGF-like biological function and via participating directly or indirectly the regulation of immunocytes to affect the pathogenesis and disease activity of UC. It might be used as a biomarker for diagnosis and assessment of disease activity and therapeutic efficacy of UC. Furthermore,it might be a potential target for treatment of UC.

Objective To explore the expression level and clinical significance of α-Arrestin domain-containing protein 3(ARRDC3)gene in human brain glioma tissues.Methods Clinical data and gene expression of patients with brain glioma were analyzed using the Chinese Glioma Genome Atlas(CGGA)database and the Cancer Genome Atlas(TCGA)database.Brain glioma specimens were collected from 9 patients with primary brain gliomas treated in the Department of Neurosurgery,the Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2021.The expression levels of ARRDC3 in gliomas of different grades were detected through immunohistochemical experiments.The expression levels of ARRDC3 in gliomas with different molecular types and grades were analyzed by using thenon-parametrictest.The effect of ARRDC3 expression on the survival time of brain glioma patients was analyzed by using the Kaplan-Meier survival curve,while the effect of ARRDC3 expression on prognosis of glioma patients was analyzed by using univariate and multivariate Cox regression models.Results Data in the CGGA and TCGA databases showed that the expression of ARRDC3 in the grade Ⅱ,Ⅲ and Ⅳhuman brain gliomas increased gradually(P＜0.05).The results of immunohistochemical staining experiments were consistent with the above results(P＜0.05).The ARRDC3 expression in isocitrate dehydrogenase(IDH)wild type glioma patients was significantly higher than that in IDH mutant glioma patients(P＜0.05).The overall survival of the patients with high ARRDC3 expression was significantly shorter than that of the patients with low ARRDC3 expression(P＜0.05).Multivariate Cox regression analysis revealed that age,IDH mutation state,radiotherapy and ARRDC3 expression were risk factors for prognosis of human brain glioma patients(P＜0.05).Conclusion With the pathological grade rising gradually,the relative expression level of ARRDC3 in human brain glioma tissues increases gradually.The prognosis of brain glioma patients with low expression of ARRDC3 is significantly better than that of patients with high expression of ARRDC3.ARRDC3 can be used as a prognostic factor for glioma patients.

Objective:To understand the status quo of self-stigma of diabetic patients in college students and analyze its influencing factors.Methods:This study was a cross-sectional study, and the convenient sampling was conducted online and offline from July 2017 to June 2020. College students with diabetes who were treated in outpatient or inpatient Departments of Endocrinology and Metabolism in 5 Class Ⅲ Grade A hospitals were selected as the research objects, and similar patients who followed 2 diabetes public accounts were selected as online supplements. General information questionnaire and China-Self Stigma Scale (C-SSS) were used for questionnaire surveys. Data were statistically processed by t-test, analysis of variance and multiple linear regression analysis. A total of 200 questionnaires were distributed, and 189 valid questionnaires were recovered, with an effective recovery rate of 94.50%. The self-stigma of 80.42% of college students with diabetes mellitus was at a medium-to-high level. The total average score of C-SSS was (2.34±0.49) , of which the mean scores of cognitive dimension, emotional dimension and behavioral dimension were respectively (2.33±0.50) , (2.41±0.57) and (2.19±0.64) . The results of univariate analysis showed that there were statistically significant differences in the stigma scores of diabetic patients with different genders, family locations, parental physical conditions, diabetes types, family history, diabetes complications and insulin treatment or not ( P<0.05) . The results of multiple linear regression analysis showed that gender and type of diabetes were factors affecting the self-stigma level of college students with diabetes mellitus ( P<0.05) . Conclusions:The level of self-stigma in college students with diabetes mellitus is generally high. Hospitals, schools and families should strengthen cooperation and pay attention to these with high level of self-stigma. Meanwhile, early prevention and control should be targeted through dynamic tracking, psychological counseling and other interventions.

Constructing a multi-tiered healthcare security system can meet the diverse and individualized healthcare service demand of the general public.Public hospitals,as the main providers of healthcare services in China,effectively integrate with commercial health insurance,which can accelerate the implementation of high-quality healthcare services,promote innovative development,and optimize product coverage and operational efficiency for commercial health insurance,achieving a win-win situation.Taking Shanghai as the research object,it analyzes the supply and demand status of multi-tiered healthcare security in Shanghai based on population characteristics,economic level,healthcare resources,and policy environment.It identifies the difficulties in the current collaboration between public hospitals and commercial insurance.Finally,it proposes exploring the expansion of independent development space for specialized services,improving the level of coordination between commercial insurance institutions and public hospitals in health management services,promoting the management and sharing of data,strengthening the protection of innovative medicines and devices by commercial insurance,in order to promote the coordinated development of commercial insurance and public hospitals.

Based on on-site research in Shanghai,it takes a supply-side perspective to examine the current status of cooperation between Private Health Insurance(PHI)and the pharmaceutical industry.It discusses the issues existing in the cooperation and proposes policy recommendations for their coordinated development.It identifies three main cooperation models and products,which are the public-private integrated product"Hui Min Bao",the special drug insurance led by insurance companies,and the disease insurance for patients led by pharmaceutical enterprises.However,these models commonly face challenges such as the limited policy support,a lack of standardized cooperation between the two sectors,insufficient information and data exchange,immature innovative payment models,and difficulties in the application of innovative drugs.It argues that the key to coordinated development lies in leveraging the strategic purchasing power of PHI,devising rational payment strategies and standards to achieve a win-win situation for insurers,enterprises,healthcare providers and patients.Therefore,policy recommendations are proposed from the perspectives of establishing mechanisms,breaking barriers,strategic procurement,and supporting measures.

Constructing a multi-tiered healthcare security system can meet the diverse and individualized healthcare service demand of the general public.Public hospitals,as the main providers of healthcare services in China,effectively integrate with commercial health insurance,which can accelerate the implementation of high-quality healthcare services,promote innovative development,and optimize product coverage and operational efficiency for commercial health insurance,achieving a win-win situation.Taking Shanghai as the research object,it analyzes the supply and demand status of multi-tiered healthcare security in Shanghai based on population characteristics,economic level,healthcare resources,and policy environment.It identifies the difficulties in the current collaboration between public hospitals and commercial insurance.Finally,it proposes exploring the expansion of independent development space for specialized services,improving the level of coordination between commercial insurance institutions and public hospitals in health management services,promoting the management and sharing of data,strengthening the protection of innovative medicines and devices by commercial insurance,in order to promote the coordinated development of commercial insurance and public hospitals.

Based on on-site research in Shanghai,it takes a supply-side perspective to examine the current status of cooperation between Private Health Insurance(PHI)and the pharmaceutical industry.It discusses the issues existing in the cooperation and proposes policy recommendations for their coordinated development.It identifies three main cooperation models and products,which are the public-private integrated product"Hui Min Bao",the special drug insurance led by insurance companies,and the disease insurance for patients led by pharmaceutical enterprises.However,these models commonly face challenges such as the limited policy support,a lack of standardized cooperation between the two sectors,insufficient information and data exchange,immature innovative payment models,and difficulties in the application of innovative drugs.It argues that the key to coordinated development lies in leveraging the strategic purchasing power of PHI,devising rational payment strategies and standards to achieve a win-win situation for insurers,enterprises,healthcare providers and patients.Therefore,policy recommendations are proposed from the perspectives of establishing mechanisms,breaking barriers,strategic procurement,and supporting measures.

Constructing a multi-tiered healthcare security system can meet the diverse and individualized healthcare service demand of the general public.Public hospitals,as the main providers of healthcare services in China,effectively integrate with commercial health insurance,which can accelerate the implementation of high-quality healthcare services,promote innovative development,and optimize product coverage and operational efficiency for commercial health insurance,achieving a win-win situation.Taking Shanghai as the research object,it analyzes the supply and demand status of multi-tiered healthcare security in Shanghai based on population characteristics,economic level,healthcare resources,and policy environment.It identifies the difficulties in the current collaboration between public hospitals and commercial insurance.Finally,it proposes exploring the expansion of independent development space for specialized services,improving the level of coordination between commercial insurance institutions and public hospitals in health management services,promoting the management and sharing of data,strengthening the protection of innovative medicines and devices by commercial insurance,in order to promote the coordinated development of commercial insurance and public hospitals.