Objective To explore the anti- inflammatory of pricking blood therapy in acute gouty arthritis rats. Methods 60 Sprague-Dawley rats were equally divided into normal group, bloodletting normal group, sham group, arthritis group, bloodletting group and ibuprofen group. The acute gouty arthritis model was established with injecting uric acid sodium salt into the right ankle joint cavity. The ibuprofen group was administrated with ibuprofen intragastrically, the bloodletting normal group and bloodletting group were pricked the right Kunlun (BL60) acupoint. The cross section diameter of the right ankle joint were measured before and after treatment. Levels of mRNA and protein of interleukin (IL)-10 and IL-4 expressed in ankle were determined with RT-PCR and Western blotting Results The cross section diameter increased in the bloodletting group compared with the normal group after treatment (P<0.05), and decreased (P<0.05) compared with the arthritis group and the ibuprofen group, while the expression of IL-10 mRNA increased (P<0.05) compared with the normal group, the arthritis group and the ibuprofen group, as well as the IL-10 protein compared with the normal group and the arthritis group (P< 0.05). The expression of IL-4 mRNA and protein increased without significance (P>0.05) in the bloodletting group compared with the normal group. Conclusion IL-10 may play a role of anti-inflammatory in pricking bloodletting therapy for acute gouty arthritis.

Objective:This study aimed to assess serum fibulin-3 levels in patients with colon cancer compared with healthy controls and its relationship to demographics and tumor pathology.Methods:A total of 97 patients (mean age,59.6 years;57.7％ males) with colon cancer and 86 controls (mean age,58.8 years;54.7％ males) were included.Serum levels of fibulin-3 were determined using a commercially available sandwich ELISA (Enzyme-Linked ImmunoSorbent Assay).Results:Preoperative serum fibulin-3 levels were significantly lower in the group of patients with colon cancer(39.86 ± 24.37) ng/mL compared with the control group (94.25 ± 31.28) ng/mL.Preoperative fibulin-3 levels and negatively correlated with the degree of tumor TNM stage (P＜0.05),fibulin-3 levels gradually decreased by tumor stage from Ⅰ to Ⅳ and the difference is statistically significant.The serum fibulin-3 levels were correlated significantly with tumor size,lymph node metastasis,distant metastasis and CEA levels(P＜0.05).Conclusion:It was concluded that fibulin-3 is expressed at a lower level in colon cancer,and it is significant correlated with tumor burden,decreased level of fibulin-3 can serve as a marker for advanced colon cancer.

OBJECTIVETo investigate the pathologic bacterial distribution and their antibiotic resistance in infants aged from 1 to 3 months with lower respiratory tract infection, so as to provide instructions for clinical application of antibiotics.

METHODSInduced sputum was extracted from 622 cases of hospitalized infants aged from 1 to 3 months with lower respiratory tract infection between January 2013 and December 2013, and microbial sensitivity test was performed with agar diffusion sensitivity test.

RESULTSA total of 379 (60.9%) strains of bacteria were isolated from induced sputum in the 622 infants. The Gram-negative strains were detected in 325 strains (85.8%), and the Gram-positive strains were found in 50 strains (13.2%) in the 379 strains. The others were Fungal strains (4 strains, 1.1%). The Gram-negative bacteria included Escherichia coli (31.1%) and Klebsiella pneumoniae (18.2%), with extended-spectrum β-lactamases (ESBLs) production of 48.3% and 52.2% respectively. The average rate of antibiotic resistance for ESBLs-producing bacteria was 53%. ESBLs-producing bacteria were highly resistant (100%) to ampicillin and cefotaxime, but sensitive to carbapenems. Staphylococcus aureus (10.0%) was the dominant bacteria in Gram-positive bacteria. A lower proportion of methicillin-resistant Staphylococcus aureus (1.8%) was observed, however the resistance rate of methicillin-resistant Staphylococcus aureus to β-lactam antibiotics were 100%.

CONCLUSIONSEscherichia coli and Klebsiella pneumoniae are the main pathogenic bacteria causing lower respiratory tract infection in infants aged from 1 to 3 months. ESBLs-producing bacteria accounted for over 48%, and the antibiotic resistance rate were more than 53% in these infants. These results provide a basis for the first empirical clinical use of antimicrobial in infants with lower respiratory tract infection.

Drug Resistance, Bacterial ; Escherichia coli ; isolation & purification ; Female ; Humans ; Infant ; Klebsiella pneumoniae ; isolation & purification ; Male ; Respiratory Tract Infections ; drug therapy ; microbiology ; Sputum ; microbiology

OBJECTIVETo evaluate the morphological change of masseter after the mandibular angle osteotomy.

METHODSComputerized tomography (CT) examination was performed on 120 patients treated by mandibular angle osteotomy before operation and at 3, 6, 12 months after operation, respectively. The pre- and postoperative masseter muscle thickness and cross-sectional area were evaluated using 3D CT images observed from 3 selected slice planes, which were paralleled with Frankfurt horizontal plane. These CT images were stored and three-dimensional reconstruction were made for calculation of masseter muscle volume through software.

RESULTSAfter operation, the reduction of the masseter muscle volume and cross-sectional area was seen. The volume of the masseter at 3, 6, 12 months postoperatively decreased to 82.02%, 77.00% and 80.43% (P < 0.05). The cross-sectional area at 3, 6,12 months postoperatively decreased to 85.81%, 78.86% and 81.56% at A plane, 80.94%, 75.03% and 77.04% at B plane, and reached to 13.46%, 11.48% and 13.89% at C plane (P < 0.05, P < 0.05, P < 0.01). The masseter thickness after operation was significantly different from that before operation during the follow-up period, but not at 12 months after operation at A plane.

CONCLUSIONSThe masseter atrophy happens spontaneously after mandibular angle osteotomy, especially at the region of mandibular angle. It should be considered during surgical design.

Adolescent ; Adult ; Female ; Humans ; Mandible ; surgery ; Masseter Muscle ; anatomy & histology ; diagnostic imaging ; Osteotomy ; Postoperative Period ; Tomography, X-Ray Computed ; Young Adult

Objective To evaluate the outcomes of children with Phenylketonuria(PKU)detected by newborn screening program.Methods One hundred and two children with PKU were detected and diagnosed in Shanxi Newborn Screening Center from June 2004 to September 2014.All children with PKU were followed up until December 2015.During the follow-up,the Phenylalanine(Phe)levels,physical and intellectual development, nutrition status of those children were monitored.Results Among 102 PKU children,there were 96(94.12%)with normal physical development,and 93(91.18%)with normal DQ/IQ.The average DQ or IQ score in children who started the therapy before 1 month was higher than that in those who started after 1 month old(93.07 ±9.50 vs.87.39 ±10.99,t=3.09, P=0.00).Among these children 82.47%(80/97)had zinc deficiency and 31.46%(28/89)had dyslipidemia; and the normal Phe concentration rate was(59.73 ±19.03)%.The intellectual development level was negatively correlated with the age of starting therapy(r=-0.25, P=0.01), positively correlated with the education levels of his/her father(r=0.21,P=0.03)and mother(r=0.23, P=0.02).And the intellectual development was better in urban areas than that in rural areas.Conclusions With the standardized treatment, the physical and intellectual development of children with PKU can basically reach normal levels,and the earlier treatment can make better therapeutic effect.

Background::With an increasing proportion of multiparas, proper interpregnancy intervals (IPIs) are urgently needed. However, the association between IPIs and adverse perinatal outcomes has always been debated. This study aimed to explore the association between IPIs and adverse outcomes in different fertility policy periods and for different previous gestational ages.Methods::We used individual data from China’s National Maternal Near Miss Surveillance System between 2014 and 2019. Multivariable Poisson models with restricted cubic splines were used. Each adverse outcome was analyzed separately in the overall model and stratified models. The stratified models included different categories of fertility policy periods (2014–2015, 2016–2017, and 2018–2019) and infant gestational age in previous pregnancy (<28 weeks, 28–36 weeks, and ≥37 weeks).Results::There were 781,731 pregnancies enrolled in this study. A short IPI (≤6 months) was associated with an increased risk of preterm birth (OR [95% CI]: 1.63 [1.55, 1.71] for vaginal delivery [VD] and 1.10 [1.03, 1.19] for cesarean section [CS]), low Apgar scores and small for gestational age (SGA), and a decreased risk of diabetes mellitus in pregnancy, preeclampsia or eclampsia, and gestational hypertension. A long IPI (≥60 months) was associated with an increased risk of preterm birth (OR [95% CI]: 1.18 [1.11, 1.26] for VD and 1.39 [1.32, 1.47] for CS), placenta previa, postpartum hemorrhage, diabetes mellitus in pregnancy, preeclampsia or eclampsia, and gestational hypertension. Fertility policy changes had little effect on the association of IPIs and adverse maternal and neonatal outcomes. The estimated risk of preterm birth, low Apgar scores, SGA, diabetes mellitus in pregnancy, and gestational hypertension was more profound among women with previous term births than among those with preterm births or pregnancy loss.Conclusion::For pregnant women with shorter or longer IPIs, more targeted health care measures during pregnancy should be formulated according to infant gestational age in previous pregnancy.

Objective The items of quality of life scale for premature ovarian insufficiency were screened using the Delphi method,thus to provide a basis for the development of the scale.Methods The core researcher group of scale development was formed firstly,and then the theoretical framework of the scale was constructed and the original item pool was established on the basis of previous literature analysis,medical record review and patient interview,Secondly,the expert consultation questionnaire was formulated,the experts were screened,and two rounds of expert investigation were conducted by the Delphi method.Finally,the survey results were statistically analyzed,the expert opinions were sorted out,and the items were screened.Results A total of 15 experts were selected,and they were from 9 provinces or municipalities directly under the central government,exerting certain discipline representativeness and authority.The two rounds of expert investigation by Delphi method were conducted by issuing 15 questionnaires in each round of expert investigation,the positive coefficient of the experts was all 100%,the authority coefficient of the experts was 0.970 and 0.963 respectively,and the Kendall's W coefficient was 0.236 and 0.381 respectively(P＜0.05).Finally,31 items(18 related with the physiological domain,8 related with the psychological domain and 5 related with the social domain)and 2 overall-evaluation items were determined.Conclusion The experts participating in the Delphi method have high authority and enthusiasm.The Kendall's W coefficient of the second-round expert investigation is higher than that of the first-round expert investigation,the experts'opinions reach unanimity,and the results are more reliable.The results of item screening of TCM quality of life scale for premature ovarian insufficiency can provide reference for the subsequent evaluation and research of the scale.

Perihilar cholangiocarcinoma(PHC)is a common malignancy of biliary tract,for which surgery is the most effective treatment.However,its prognosis is not satisfactory even after surgical resection.In recent years,there have been some new advances in the surgical treatment of PHC.In this paper,we reviewed the existing literatures,demonstrated the current situation of preoperative biliary drainage,liver hyperplasia,hepatic resection,liver transplantation and minimally invasive surgery in the treatment of PHC,and prospected the future research direction.

OBJECTIVETo investigate the current situation of drug cost, hospitalization cost and direct medical expense in community health management of hypertensive patients, in order to lay foundation for evaluating whether the community health management in basic public health service has cost-effect in Health Economics.

METHODSA total of 8326 hypertensive patients from 10 survey pilots in 5 provinces were selected by cluster sampling methods, including 3967 patients who took part in community health management for over 1 year as management group and 4359 cases who have never taken part in community health management as control group. The essential information of research objects were collected by questionnaire; and the medical cost information in the last year (from November 2009 to November 2010) were collected retrospectively. The different annual medical treatment cost, hospitalization cost and direct medical expense in the two groups were compared and analyzed.

RESULTSThe average annual drug cost in hypertension was (621.50 ± 1337.78) yuan per patient; while the cost was (616.13 ± 1248.40) yuan in management group and (626.44 ± 1414.30) yuan in control group respectively. The average annual drug cost of hypertensive patients who took medicine therapy was (702.05 ± 1401.79) yuan per person, while the cost in the management group ((688.50 ± 1300.70) yuan) was much lower than it in control group ((714.64 ± 1489.60) yuan). The annual average drug cost in urban was (731.88 ± 1403.31) yuan per person, which was higher than it in rural as (407.44 ± 1171.44) yuan per person. The average hospitalized rate was 12.2% (1014/8326), and the average annual cost among the hospitalized patients was (9264.47 ± 18 088.49) yuan per person; while the cost was (7583.70 ± 13 267.00) yuan in management group, which was lower than it in control group as (11 028.00 ± 21 919.00) yuan. The average annual hospitalized cost in hypertension was (1064.87 ± 6804.83) yuan per person; while the cost was (936.73 ± 5284.90) yuan in management group, which was lower than it in control group as (1181.50 ± 7937.90) yuan. The average annual direct medical expense in hypertension was (2275.08 ± 8225.66) yuan per person; while the expense was (2165.10 ± 6564.60) yuan in management group and (2375.20 ± 9487.60) yuan in control group. The average annual direct medical expense in urban ((2801.06 ± 9428.54) yuan per person) was higher than it in rural ((1254.70 ± 4990.27) yuan per person).

CONCLUSIONThe community health or standardized management of hypertensive patients can reduce the average annual drug cost and hospitalization cost (around 26 yuan and 245 yuan separately); and thereby save the annual direct medical expense per capita in hypertension (around 210 yuan). In the reform and development of national medical health system, we should enhance and promote the standardized community health management of hypertensive patients.

Aged ; Community Health Services ; economics ; Cost-Benefit Analysis ; Drug Costs ; Female ; Health Care Costs ; statistics & numerical data ; Humans ; Hypertension ; drug therapy ; economics ; Male ; Middle Aged ; Public Health ; economics

OBJECTIVETo investigate the status of the clinical agency of detection, management, and health insurance for hypertensive patients in urban and rural communities of five provinces in China in 2010, in order to provide fundamental data for implementation and evaluation of community health management of hypertensive patients in basic public health service.

METHODSFrom Jiangsu, Shandong, Hebei, Sichuan and Gansu provinces, cities and districts (counties) were selected according to economic development level and 10 survey sites were finally determined. In each survey site, 3-4 communities or townships were selected by cluster sampling methods in 2010. A total of 8326 eligible hypertensive patients (4363 in urban and 3963 in rural) were included. The urban-rural difference of clinical agency and health insurance was compared for hypertensive patients.

RESULTSIn urban areas, 43.74% (1867/4268) hypertensive patients were first diagnosed at hospitals of district level or above, 25.07% (1070/4268) at community health service centers (CHSC), and 20.20% (862/4268) at community health service stations (CHSS), respectively; 30.72% (1274/4147) and 31.11% (1290/4147) patients chose CHSC and CHSS for their follow-up visiting, respectively; 60.23% (3073/5102) antihypertensive medication was obtained from pharmacies. In rural areas, 54.58% (2133/3908) hypertensive patients were first diagnosed at village clinics, 22.36% (874/3908) at township hospitals, and 18.86% (737/3908) at hospitals of county level or above; 70.49% (2695/3823) patients chose village clinics for their follow-up visiting; 46.23% (2116/4577) antihypertensive medication was obtained from village clinics, and 36.29% (1661/4577) from pharmacies. The main reasons for choosing clinical agency for both urban and rural patients were convenience (45.79%, 6276/13 706) and low cost (11.78%, 1614/13 706). The proportions of reimbursements for hospitalization expenses and total medical expenses for hypertensive patients in urban in the past year were 66.67% and 34.78%, respectively, which were much higher than those in rural (35.71% and 9.50%) (Z value was -12.13 and -17.56, P < 0.01).

CONCLUSIONCommunity-based hypertension detection and routine blood pressure measurement during clinical visiting should be further strengthened to improve early diagnosis of hypertension. The development of community-based clinical agency should be able to provide convenient and low cost health service for hypertensive patients to improve treatment, follow-up and control of hypertension.

Adult ; Aged ; China ; Cities ; Community Health Services ; Female ; Humans ; Hypertension ; diagnosis ; therapy ; Insurance, Health ; Male ; Middle Aged ; Public Health ; Rural Health Services ; Urban Health Services