Before 2002, the three existing basic medical security systems of Thailand covered 30% of the population, and the surplus population participated in the universal coverage(UC)policy of medical security system which promulgated in 2002. Since the implement of UC policy, it has improved the equity of medical service application and health financing, reduced Catastrophic Health Payments and low-income groups have obtained more benefits. The incidence rate of Catastrophic Health Payments decreased and the spending burden of catastrophic health expenditure in low-income groups decreased from 6.11%(2000)to 4.65%(2002).

Objective To evaluate the quality of examination papers of otolaryngology among students of grade 2007 in the first clinical college of Chongqing Medical University.Methods Totally 202 copies of examination papers of otolaryngology from grade 2007 students in our college were taken as research references.SASS 15.0 software was used to statistically analyze total score of every student and score of each question.Mean score,standard deviation,difficulty coefficient and discrimination coefficient of each question were counted and normality test was conducted.Results Scores were in negative skewness distribution,with mean score of 80.9,standard deviation of 10.9,the lowest score of 56.5,the highest score of 98.0,difficulty coefficient of 0.781,and discrimination coefficient of 0.308.Conclusions Examination papers are well designed and discriminated and can objectively reflect students' command of the course.However,distribution of sores is unreasonable and examination paper is relatively easy to complete,indicating the weakness in the teaching process.

Objective To study the effect of Bushen Tiaojing Chinese herbs on the expressions of endometrial integrin ?3 in infertile patients with polycystic ovary syndrome (PCOS) receiving ovulation induction therapies. Methods Thirty-six PCOS related infertility patients were divided into 2 groups at random, receiving different ovulation induction therapies:17 patients of group A were given clomephine citrate (CC)/human chorionic gonadotropin (hCG) therapies, and 19 patients of group B were given CC/ hCG combined with Chinese herbs therapies. 22 infertile women with fallopian tubal or male infactors were chosen as controls. The mRNA expressions of integrin ?3 in midluteal endometrium were measured by reverse transcription-polymerase chain reaction. Results Compared with controls, the expressions of endometrial integrin ?3 were weaker in group A (P0.05). Conclusion CC/hCG ovulation induction therapies may induce the decline of endometrium receptivity during midluteal phase, which Chinese herbs may promote.

AIM: To observe the effect of puerarin on myocardial injury according to the time of occurrence of myocardial injury in the development of type 2 diabetic mice.METHODS: The serum levels of glucose(GLU),triglyceride(TG),total cholesterin(TC),low density lipoprotein-cholesterol(LDL-C) and high density lipoprotein-cholesterol(HDL-C) in 17-week,20-week,24-week,28-week KKAy mice were detected by automatic biochemical methods.The apoptotic percentage of cardiomyocytes was examined by flow cytometry.The expressions of bax and bcl-2 mRNA in cardiomyocytes were detected by RT-PCR.Caspase-3 expression in cardiomyocytes was determined by immunohistochemical staining.RESULTS: Compared to normal control mice,not only GLU level increased,but also the levels of TG,TC,LDL-C,HDL-C in 20-week,24-week and 28-week KKAy mice increased apparently(P

Objective To investigate the effect of combined auricular acupuncture therapy on blood glucose in type 2 diabetic patients.Method Sixty type 2 diabetic patients were randomly allocated to a treatment and a control group, 30 cases each. The control group was intervened by conventional medication, while the treatment group by combined ear point therapy (ear point massage, bloodletting and seed embedding) in addition to the intervention given to the control group. After 3 months treatment, fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin were measured in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in the indicators (fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin) in the treatment group (P<0.01). There were statistically significant post-treatment differences in the indicators between the treatment and control group (P<0.01).Conclusions Combined auricular acupuncture therapy is an effective way to treat type 2 diabetes. It has a better hypoglycemic effect.

Objective To analyze the consistency of transcutaneous perianal ultrasonography (TPUS) and pelvic magnetic resonance imaging (MRI) in diagnosing perianal lesions of Crohn's disease (CD), and to evaluate the value of transcutaneous perianal ultrasonography in detecting perianal lesions of CD. Methods A cohort of 102 patients diagnosed as Corhn's disease were enrolled from August 2008 to August 2010. Perianal abscess and fistula of these CD patients was diagnosed by ultrasonography and MRI system. Statistics was performed with SPSS 11.5 software for X2 test. The consistency was analyzed with Kappa test. Results The mean onset time of perianal lesions in CD was -0.443 year (95％CI:-1.659～0.773 year) before typical symptoms showed up. There was no significant difference in detecting perianal lesions of CD between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging (P ＝ 0.706, Kappa ＝ 0.541). If pelvic magnetic resonance imaging was considered as the golden standard in detecting perianal lesions of CD,the sensitivity (Sen), specificity (Spe), Youden's index, positive predictive value (PPV) and negative predictive value (NPV) of TPUS were 72.73％, 82.61％, 0.55, 66.67％ and 86.36％ respectively.Furthermore, there was no significant difference between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess ( P ＝ 0.706, Kappa ＝ 0.496) and fistula (P＝0.655, Kappa＝0.546) of CD. Conclusions Perianal lesions occur in the entire course of CD. There was favorable consistency between transcutaneous perianal ultrasonography and pelvic magnetic resonance imaging in detecting perianal abscess and fistula of CD. Transcutaneous perianal ultrasonography can be used as an additional method in detecting and evaluting perianal lesions of CD.

Objective To investigate the effects of stellate ganglion block (SGB) on erythrocyte immunity in patients with acute cerebral infarction.Methods Twenty-four patients (13 male, 11 female) who developed acute cerebral infarction for less than 3 days were randomly divided into 2 groups (n=12each): Group A receiving traditional treatment and Group B receiving traditional treatment + SGB.The patients ranged in age from 51 to 64 yr and weighed 52-71 kg. All patients received intravenous 5% glucose 25 ml plus citicoline sodium 1.0 g and sodium ozagrel injectio 250 ml daily for 10 days in addition to dehydration and effective control of complications and intracranial pressure. Group B received SGB on one side alternatively with 1% licocaine 10 mi once a day for 10 days. Fasting venous blood samples were taken in the early mornings of the day before treatment (baseline, T1 ) and the 1st, 5th and 10th day of treatment (T2-4) for determination of the plasma MDA concentration and SOD activity, erythrocyte C3b receptor rosette rate (RBC-C3bRR) and RBC immune complex rosette rate (RBC-ICR) and Ne+-K+-ATPase activity in erythrocyte membrane.Results The plasma MDA concentration and RBC-ICR were significantly decreased during treatment es compared with the baselines at T1 in both groups (P＜0.05 or 0.01), but were significantly lower in Group B than in Group A (P＜0.05 or 0.01 ).The activities of plasma SOD and Na+ -K+ -ATPase in erythrocyte membrane and RBC-C3bRR were significantly increased during treatment as compared with the baselines at T1 and were significantly higher in Group B than in Group A.Conclusion SGB combined with traditional treatment can increase the activities of plasma SOD and Na+ -K+ -ATPase in erythrocyte membrane, inhibit production of oxygen free radicals and enhance RBC immune function in patients with acute cerebral infarction.

Aneurysm, False ; pathology ; Carotid Artery, Internal ; pathology ; Humans ; Male ; Sphenoid Sinus ; pathology ; Young Adult

The internal medicine of paediatrics is the important major course in paediatrics. Focusing on strengthening the constructionof staff, we cultivate all levels of teachers from different administrative level and personality, do schorlarly research meticulously,standardizing management and improve the teaching evaluation system. Besides we promote the construction and development of theinternal medicine of paediatrics by carrying out teaching research, impsoving teaching methods and making paediatics the key subjectin China.

Abstract: Objective　To compare the different effects of body mass index (BMI) and lean body mass index (LBMI) on the risk of all-cause death among elderly Chinese individuals. For the more scientific, accurate and convenient measurement of the elderly physique, analysis and evaluation of the health risk factors of the elderly in China. Methods　This study is based on follow-up data from 2014 to 2018, involving 5 990 participants who met the inclusion criteria in the Chinese Longitudinal Healthy Longevity Survey. Participants were grouped according to their BMI and LBMI, and both univariate and multivariate Cox proportional hazard models were established to compare the effects of BMI and LBMI on the risk of death in the elderly. According to gender, age, activities of daily living, and comorbidities, subgroup analysis was conducted to study the influence of LBMI in different subgroups. Results　The study population predominantly comprised females (52.9%, 3 167/5 990), with an average age of (84.7 ± 10.1) years, and most participants lived in rural areas (55.1%, 3 298/5 990). A majority were non-smokers (82.7%, 4 952/5 990) and non-drinkers (84.3%, 5 050/5 990). The prevalence of hypertension was 32.8% (1 966/ 5 990), diabetes 5.6% (334/5 990), and heart disease 12.9% (774/5 990). In the analysis of the impact of BMI on all-cause death in the elderly, univariate analysis showed that an increase in BMI was associated with a reduced risk of mortality. After adjusted by multiple factors (age, gender, living environment, marital status, average arterial pressure, number of children, smoking, drinking, hypertension, diabetes, heart disease, cerebrovascular disease, tumor, ADL/IADL, number of complications), compared to the normal group, the emaciated group (BMI<18.5 kg/m2) had the highest risk of death (HR=1.15,95%CI: 1.01-1.30); the overweight group (24.0 kg/m2≤BMI<28.0 kg/m2) had a lower risk of death (HR=0.78, 95%CI: 0.67-0.91). In the analysis of the impact of LBMI on the risk of death in the elderly, compared to moderate LBMI, lower LBMI was associated with a higher risk of death. Multivariate analysis showed that compared with moderate LBMI, a decrease in LBMI increased the risk of death, whereas an increase in LBMI did not show statistically significant differences in mortality risk in the elderly. Conclusion　In measuring fitness and quality of life in the elderly, LBMI has better representativeness and practical value.