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.

Objective To evaluate the quality of life(QOL)of postpartum women within six months after delivery in Pudong New Area in Shanghai.Methods From January 1st to June 30th in 2011,435 postpartum women,discharged from Children and Women's Health Care Hospital in Pudong New Area,Gaoqiao Community Health Service Center and Lujiazui Community Health Service Center in Pudong New Area,were investigated by SF 36 questionaire including eight items [physical functioning (PF),role limitations due to physical problems (RP),bodily pain (BP),general health (GH),vitality (VT),social functioning (SF),role limitations due to emotional problems (RE) and mental health (MH)] and divided into three subgroups according to the duration after delivery (8-42,43-119 and 120 180 d).The SF-36 scores were compared with the control (baseline data of 25 to 36-year-old young women in Pudong New Area) or within the three groups.Statistical methods,such as t-test and analysis of variance,were applied.Results (1) The tota lscore and the scores of the seven items in SF-36 were lower than those of control (total score:74.2±11.7 vs 80.5,PF:79.0±19.0 vs 94.6,RP:47.5±12.2 vs 85.7,BP:74.0±18.7 vs 78.4,GH:73.9±13.1 vs 71.0,VT:69.8±16.2 vs 75.0,SF:78.3±20.1 vs 86.9,RE:63.4±21.7 vs 83.5,t=-11.225,-17.105,-18.914,-4.893,3.688,-6.642,-8.881 and-10.076,all P＜0.05) and no significant difference was found in MH score between the postpartum women and the control (78.3±15.0 vs 77.8,t=0.629,P＞0.05).Compared the SF-36 scores in three subgroups (8 42,43-119 and 120 180 d postpartum),the differences on PF score(73.0±19.1,86.3± 17.1,89.1±12.9),RP score(32.4±18.6,57.7±19.1,79.9±12.0),BP score(70.7±18.0,75.6±19.0,81.6±17.3),SF score(76.3±19.6,78.2±21.7,83.9±19.3),RE score(58.5±12.9,71.4± 18.3,70.1± 19.5) and SF-36 total score (72.2± 11.1,76.1± 12.8,78.0± 11.1) were all significant (F=37.744,60.640,13.137,5.185,4.577 and 10.548,allP＜0.05).The PF,VT,RE and total score of postpartum women at 120-180 days after delivery were still lower than those of the control group(t=-4.174,-2.353,-3.341 and-2.166,all P＜0.05).Conclusions The QOL of postpartum women within six months after delivery is not good enough.Up to 120-180 days after delivery,the QOL remains.More efforts should be made to improve the QOL of postpartum women by the whole society.

Objective To investigate the effect of home diabetes care platform based on internet and family fixed partner on the continuous care of diabetes patients outside the hospital.Methods A total of 150 out-patients with diabetes were collected from June 2016 to November 2016,divided into family fixed partner group(group A),smart phone APP home diabetes care platform group(group B),family fixed partner combination with smart phone APP home diabetes care platform group(group C)with 50 cases each by random digits table method.The three groups received the same health education during their stay in hospital,patients in group A and group C were required to have family fixed partners,patients in group B and group C were required to receive the home diabetes care platform for smart phones APP after they left the hospital,the intervention time was six months,and the indexes of blood glucose metabolism,self-management ability of diabetes were assessed at the end of six months after intervention and before intervention.Results Fasting blood glucose and postprandial blood glucose and glycosylated hemoglobin values of the three groups after intervention were lower than those before intervention.The postprandial blood glucose and glycosylated hemoglobin values was(9.96±4.23)mmol/L,(7.16±1.47)%in group C,(13.78±3.34),(11.46±4.85)mmol/L and(8.46±2.21)%,(8.07±2.45)%in group A and B,the difference was significant(F=10.57,3.92,P＜0.05).The scores of self-management ability of diabetes of the three groups after intervention were all higher than those before intervention.The score of self-management ability of diabetes of item 1-6 was(6.45±1.65),(4.87±2.23),(6.17±2.12),(5.24±1.65),(4.67±2.13),(6.27±2.02)points in group C,(5.78±1.96),(3.63±2.14),(5.25±2.34),(4.12±1.97),(3.65±1.34),(5.26±2.21)points in group B,(5.04±1.78),(3.37±1.64),(4.63±1.87),(4.03±2.17),(3.32±1.74),(5.30±1.97)points in group A,the difference was statistically significant(F=3.82-7.94,P＜0.05).Conclusions Home diabetes care platform based on internet,combined with family fixed partner education,are more conductive to patient blood sugar control,and enhance self-management ability and account ability.

Objective To investigate the value of serum markers in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy (MHE). Methods A prospective analysis was performed for 81 patients who were hospitalized and treated in General Hospital of Ningxia Medical University from April 2020 to February 2022, and all these patients were diagnosed with hepatitis B cirrhosis based on clinical manifestation, laboratory examination, and radiological examination or liver biopsy. According to digital connection test A (NCT-A) and digital symbol test (DST), these patients were divided into simple cirrhosis group with 45 patients and MHE group with 36 patients. Related indices were measured, including liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (TBil)], albumin, blood ammonia, cholinesterase, and prothrombin time. The independent samples t -test was used for comparison of normally distributed continuous data between two groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The logistic regression analysis and the area under the ROC curve (AUC) were used to investigate the predictive factors for MHE. Results Compared with the simple cirrhosis group, the MHE group had a significant increase in NCT-A score ( Z =-7.110, P < 0.001) and a significant reduction in DST score ( t =12.223, P < 0.001). The univariate analysis showed that there were significant changes in AST, albumin, prothrombin time, cholinesterase, and blood ammonia in the patients with MHE ( Z =-2.319, -2.643, -1.982, -6.594, and -5.331, all P < 0.05), while the multivariate analysis showed that only cholinesterase and blood ammonia were significant predictive factors (all P < 0.05) and were correlated with Child-Pugh score (all P < 0.05). Cholinesterase, blood ammonia, and their combination had an AUC of 0.925, 0.845, and 0.941, respectively, in the diagnosis of MHE, with an optimal cut-off value of 2966, 60, and 0.513, respectively. Conclusion Blood ammonia, cholinesterase, and their combined measurement have a potential clinical value in the early diagnosis of liver cirrhosis with MHE.