Objective To identify the chief factors influencing health insurance patients' hospitali-zation expenses so as to provide basis for the control of irrational increase in medical expenses and reform in the mode of medical insurance payment. Methods All the medical insurance cases involving the three disease entities in two hospitals of a certain city for the past three years, which totaled 647, were collected and a statistical analysis was made of the possible influencing factors using multi-stepwise regression analysis. Results The factors influencing the health insurance patients' hospitalization expenses included choice of hospitals, length of stay, performance of operations, proportion of drug fees, and province- wide readjustment of medical service prices. Reducing length of stay and lowering proportion of drug fees were the key to controlling expenses. Conclusion It is imperative to formulate scientific diagnostic and treatment routines and expense standards for single disease entities, speed up and deepen reform in the medical insurance system, and, on the basis of trying out payment based on certain single disease entities, implement payment based on disease entities.

This paper briefly introduced the characteristics, origin and development of virtual reality, and the value for rehabilitation; reviewed the application of virtual reality in the rehabilitation of balance function after stroke. Some assessment commonly used for balance function were summarized.

Objective To investigate the effect of Astragalus Polysaccharide on peripheral circulation myeloid derived suppressor cells (MDSC) in lung cancer and its clinical effect. Methods 100 patients with advanced non small cell lung cancer were selected and divided into 2 groups, 50 cases in the control group treated with chemotherapy aalone, 50 cases in the experiment group received injection of Astragalus Polysaccharide on the basis of the control group, peripheral blood MDSC levels, peripheral blood T lymphocyte subsets levels, serum ARG I activity, TNF-α, IL-6 levels, the clinical effect and incidence of adverse reactions were compared after the treatment. Results Compared with the control group, peripheral blood levels of MDSC (Lin-HLA DR-\CD33+\CD11b+) was lower after treatment in the experiment group , peripheral blood levels of CD3+, CD4+T lymphocytes and CD4+/CD8+ were higher, and CD8+T lymphocytes level was lower after treatment, serum levels of ARG I activity, TNF-α, IL-6 levels were lower after treatment, (P<0.05) , the total effective rate in the control group(42.0%)was lower than the experiment group(64.0%), (P<0.05), the incidence of gastrointestinal reaction(40/24), 3 ~ 4 degree of leukocyte reduction(26/12), liver function damage(19/9), renal damage(17/7) in the control group were higher than the experiment group (P<0.05). Conclusion Astragalus Polysaccharide can significantly reduce the peripheral circulation MDSC (Lin-HLA DR-\CD33+\CD11b+) level in patients with lung cancer, improve T lymphocyte immune function, inhibit the activity of serum ARG I, reduce the level of TNF-αand IL-6, effectively improve the clinical efficacy, and reduce the toxic and side effects of chemotherapy.

To analyze six cases concerning clinical features, the treatment process and curative effect of Rhinolith. The six patients had unilateral nasal obstruction, three of them were accompanied with purulent nasal discharge, two had blood with them, one patient had repeated hemorrhage of nasal cavity and two patients had developed headache. By using endoscopic, four irregular stones which are yellow, gray and brown were found in the middle and back end. Because of the severe nasal septum deviation and inferior turbinate polypoid, the stone could not be seen clearly but could be touched by aspirator. In sinus CT examination of 6 cases, it showed incomplete irregular shapes and had high density unilateral nasal cavity in the posterior segment. 4 patients had nasal deviation, 3 patients had ipsilateral sinusitis. 4 patients removed their stone by using endoscopy, 2 patients took the stone away after correction of nasal septum. Pathologic diagnosis: rhinolith. Two patients also had exogenous foreign matters which were considered as pseudo nasal stones.
Back ; Calculi ; Endoscopy ; Headache ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum ; Nose Diseases ; pathology ; surgery ; Paranasal Sinuses ; Sinusitis ; Turbinates

Inflammatory bowel disease (IBD)includes Crohn’s disease (CD)and ulcerative colitis (UC).The differential diagnosis between CD and UC mainly depends on clinical symptoms,endoscopy,pathological biopsy,laboratory and imaging examinations.In recent years,studies with a variety of IBD-related biomarkers develop rapidly because of its non-invasiveness,simple and easily acceptable.With the development of genome-wide association study (GWAS),great progress has been achieved in studies of gene mutations and susceptibility genes related with CD and UC,which provides new approach for diagnosis of the disease.This article reviewed the advances in studies on serum biomarkers and susceptibility genes in differential diagnosis of IBD.

Background:Enteroids are considered to be the best tool for studies on intestinal epithelium in vitro and have a widely application prospects,however,there are no associated reports in China. Aims:To establish and optimize the culture technique for enteroids and provide a fantastic platform for the basic research of small intestinal epithelial cells in China. Methods:L-WRN cells were cultured routinely and the conditioned medium with different concentrations of fetal bovine serum(FBS)was collected. Six to eight weeks old C57BL/ 6 mice were sacrificed and 15 cm small intestine from the terminal ileum was removed and cut longitudinally. Crypts were digested with EDTA and then collected and embedded in Matrigel? Matrix;after polymerization of Matrigel? Matrix,L-WRN conditioned medium at different concentration gradient was added. The budding ratio and length of buds were measured dynamically under microscope. The enteroids were re-embedded for subculture when certain length of buds was reached. Results:Compared with L-WRN conditioned medium containing 20% FBS,the conditioned medium containing 10% FBS was more favorable for enteroids culture in vitro. When conditioned medium accounted for 10% ,15% ,20% ,25% or 30% of the mixed medium,they all promoted the growth of enteroids and the 15% one seemed to yield better result. Conclusions:An enteroids culture technique was successfully established for the first time in China. When the L-WRN conditioned medium containing 10% FBS accounts for 15% of the mixed medium,it might promote budding better than the others.

Objective To assess the agreement of different endoscopy grading or scoring systems for inflammatory bowel diseases(IBD)including ulcerative colitis(UC)and Crohn's disease(CD).Methods A standardized table was prepared based on the searches for endoscopic grading or scoring systems on Medline and Chinese Biomedical Database,the data of 80 patients with UC and 31 with CD.who underwent colonoscopy in Shanghai Renji hospital from June 2006 to February 2007,were evaluated with each system by two physicians independently.Data were analyzed with SPSS 13.0.Results Six endoscopic grading and scoring systems of UC and three of CD were included for evaluation.For the systems of UC and CD,Kendall's coefficients of concordance were 0.71(P<0.01)and 0.34(P<0.01),respectively.There was no significant differenee between every two systems for UC.Nonetheless.Spearman's correlation coefficient between Chinese Grading System of Crohn's Disease(CGSCD)and Crohn's Disease Endoscopic Index of Severity(CDEIS)was 0.32(P=0.08).Significant differences in frequencies were detected in endoscopic systems for UC by Kruskal Wallis test(P<0.01).Conclusion There is satisfactory concordance among the endoscopic grading and scoring systems of UC,while CGSCD needs further improvement.Furthermore,Jeroen elassifieation inclines to severe category,while modified Baron scale tends to be a mild one.

Objective To compare the effect of virtual reality (VR) based balance training and routine balance training on static and dynamic balance function in stroke patients with hemiplegia. Methods 20 stroke patients with hemiplegia were randomly divided into experimental group (n=10) and control group (n=10). Both groups received routine neurology medication and rehabilitation training. The experimental group received balance training based on 3 VR games: City Ride, The Boat and Road Encounter, while the control group received routine balance training. They were assessed with Berg Balance Scale (BBS) and Timed Up and Go Test (TUGT), and their postural stability and limits of stability were measured with STABLE system before and 4 weeks after training. Results The scores of BBS and TUGT improved in both groups after training (P<0.001), and improved more in the experimental group than in the control group (P<0.001), as well as some of the parameters of postural stability and limits of stability (P<0.05). Conclusion Balance training based on VR is more effective than routine balance training on the static and dynamic balance function of stroke patients with hemiplegia.

Giant lymph node hyperplasia (Castleman's disease) is a rare disease, which represents a peculiar form of lymph node hyperplasia. Generally, it has been considered as benign and localized disease but recently, revealed malignant transformation in some cases of multicentric form. It usually occurs on the mediastinum and occasionally neck, lung, axilla, mesentery, broad ligament, retroperitoneum or soft tissue of extremities. Histopathologically, it is divided into hyaline vascular or plasma cell type and the former is characterized with prominent vascular proliferation and hyalinization in the central portion and tight concentric layering of lymphocytes at the periphery of the follicles (mantle zone) and the latter is characterized by a diffuse plasma cell proliferation in the interfollicular area. From the point of view of clinical presentation, it has been divided into solitary form, which presents as a localized mass located most commonly in the mediastinum, and multicentric form, which occurs multiple location and has systemic manifestation and transformation into malignancy. Herein we report a case of Giant lymph node hyperplasia occurring in the left spermatic cord in a 58-year old male with brief review of literatures.
Axilla ; Broad Ligament ; Extremities ; Female ; Giant Lymph Node Hyperplasia* ; Humans ; Hyalin ; Hyperplasia ; Lung ; Lymph Nodes ; Lymphocytes ; Male ; Mediastinum ; Mesentery ; Neck ; Plasma Cells ; Rare Diseases ; Scrotum ; Spermatic Cord*