China has not established the national long-term care insurance system, the long-term care expenses being mainly borne by the family, which leads to an unclear long-term care service utilization. This paper analyzes the impact of medical and pension insurance on the long-term care expenses for the Chinese disabled elderly by con-structing a two-part model based on the data of Chinese elderly longitudinal healthy longevity survey conducted in 2011 . The results showed that the long-term care expenditure of the urban elders with disabilities is significantly high-er than that of the rural ones. Although free public health insurance, the New Rural Cooperative medical insurance and endowment insurance have certain impact on the elderly long-term care expenditure, their effectiveness is differ-ent between the rural and urban areas. The urban elders' medical and pension insurance exerts influence on both the existence and the amount of the long-term care expenses. However, the rural elders' medical and pension insurance only have impact on the existence of the long-term care expenses, but the effect is not significant. It is suggested that China has to strengthen medical and pension insurance and build long-term care insurance system to lighten the finan-cial burden of the families of elders with disabilities.

Objective To explore the application value of 256 slice helical multi phase CT scan-ning and three-dimensional reconstruction in the diagnosis of malignant tumor of colorectal obstruction. Methods Using 256 slice spiral CT scanning and three-dimensional reconstruction of multi period in 42 ca-ses of malignant tumor patients with colorectal obstruction, the results and pathological results were analyzed and the postoperative stage.Results Forty-two cases of malignant tumors of colorectal obstruction, 256 slice spiral CT could well reflect the situation of location, range, degree, peripheral intestinal lymph node and distant metastasis, CTA could show the tumor supplying artery and branch sources, on the tumor loca-tion and overall accuracy.Conclusions 256 layer spiral CT scan and three dimensional reconstruction technology is accuracy for clinical diagnosis on malignant tumor of colorectal obstruction.

The determination and characterization of solid drug form polymorphisms plays an important role in drug quality control, selection of the production process and clinical efficacy evaluation. Vibrational spectroscopy is a powerful method for the characterization of drug polymorphisms. In this paper we review recent research and application advances in the polymorphic characterization of active pharmaceutical ingredients (APIs) and drug cocrystals/salts by using Fourier transform infrared (FTIR) and Raman spectroscopy to elucidate the characteristics of APIs and drug complexes. This may provide theoretical support for structural analysis during the development process for drugs.

Objective: To evaluate the value of multi slice computed tomography (CT) in differential diagnosis of renal clear cell carcinoma and renal papillary carcinoma. Methods: The CT images of 47patients with renal cell carcinoma (RCC) were reviewed. The RCC patients were divided into 2 groups pathologically, including 37 cases of clear cell RCC and 10 cases of papillary RCC. Plain scan and three phase (corticomedullary, nephrographic and excretory phases) CT were performed in all patients. Age and sex of patients, tumor size, enhancement degree and pattern (homogeneous, heterogeneous and predominantly peripheral), the presence of calcification or cystic degeneration (necrotic or hemorrhagic areas within the tumor) and tumor spreading (including perinephric change, venous invasion and lymphadenopathy) were compared between the 2 subtypes. Results: The degrees of enhancement were significantly different between the 2 subtypes in the corticomedullary, parenchymal and excretory phases (P<0.05). Necrosis and cystic degeneration were more evident in the clear cell RCC than in papillary RCC regardless of tumor size (P<0.05). A hypervascular pattern (higher tumor enhancement after contrast material injection due to higher vascularity) was noted in 21.6% of clear cell RCC cases and in 10% of papillary RCC (P<0.05). Half of the clear cell RCC and 2.7% of papillary RCC patients showed homogeneous enhancement (P<0.05). Calcification was evident in 21.6% of clear cell RCC patients and 20% of papillary RCC patients. Conclusion: The degree of enhancement is the most valuable parameter for differentiation of clear cell RCC and papillary RCC. The presence of cystic degeneration, hemorrhage, vascularity and enhancement patterns can also contribute to the differentiation of the 2 subtypes.

Since the concept of "artificial intelligence" was introduced in 1956,it has led to numerous technological innovations in human medicine and completely changed the traditional model of medicine.In this study,we mainly explain the application of artificial intelligence in various fields of medicine from four aspects:machine learning,intelligent robot,image recognition technology,and expert system.In addition,we discuss the existing problems and future trends in these areas.In recent years,through the development of globalization,various research institutions around the world has conducted a number of researches on this subject.Therefore,medical artificial intelligence has attained significant breakthroughs and will demonstrate wide development prospection in the future.

Objective:To observe the difference of results of treadmill exercise test (TET) between male smokers and non-smokers .Methods:A total of 200 men with long-term smoking ≥20 cigarette per day were screened from outpatients and treated as smoking group .Another 200 men with similar age ,who didn’ t smoke at all ,were regarded as non-smoking control group (control group) .There were no medical history for hypertension ,hyperlipidemia ,diabetes ,and were nega-tive for electrocardiography and color echocardiography (exclude left ventricular hypertrophy etc .organic heart disease) in two groups .TET results and incidence rate of acute myocardial infarction (AMI) within two years were compared between two groups .Results:Compared with control group ,there were significant rise in TET positive rate (37. 5% vs .57. 5% , P<0.001) and incidence rate of AMI (8.5% vs .17.5% ,P=0.007) within two years in smoking group .Conclusion:Risk of suffering from coronary artery disease is more high in smokers among men .

Objective: To evaluate the repair method and its curative effects on defects and joint instability in elderly patients with recurrent soft tissue sarcoma around the knee after wide excision. Methods:Our study included 6 elderly patients with limb sal-vage and effective preoperative chemotherapy. These patients underwent extended resections, including internal or lateral articular cap-sule and collateral ligament excisions. Owing to polyleptic soft-tissue sarcoma around the knee, formed soft-tissue defects, and joint in-stability, collateral ligament and/or partial articular capsule was reconstructed using #5 Ethibond sutures. Simultaneously, soft-tissue de-fects around the knee were repaired by composite-wide pedicled fasciocutaneous flaps or medial head of gastrocnemius muscle flaps of the leg. The maximum flexion angles of the knee (MFKs) were observed and statistically tested before and during surgery, with a fol-low-up period of 6 months. Results: The immediate stability of the joints and complete coverage of the soft tissue defects were achieved during the surgery. The MFKs during preoperative treatment, intraoperative treatment, and six-month follow-up were 115.0° ± 7.8°, 101.7° ± 9.3°, and 104.8° ± 10.2°, respectively, with significant differences between the preoperative and intraoperative MFKs (t=2.68, P<0.05). By contrast, no difference existed between the intraoperative and six-month follow-up MFKs (t=0.55, P>0.05). Conclu-sion:This repair method can be applied to elderly patients with polyleptic soft tissue sarcoma around the knee by using simple, fast, and reliable surgical techniques for the reconstruction, stability, and repair of soft tissue defects in the knee joint.

Objective To study the correlation between the blood selenium level and glutathione peroxidase(GSH-Px)with the occurrence of gestational diabetes mellitus(GDM).Methods Among 1 360 pregnant women in our hospital from January 2011 to December 2012,68 cases GDM were diagnosed as GDM (observation group)and other 113 non-GDM pregnant women were ran-domly selected from these 1360 pregnant women as the control group.The serum selenium level and GSH-Px activity were com-pared between the two groups.Results The selenium level and GSH-Px activity in the control group were higher than those in the observation group.The selenium level was (3.07±0.51)mmol/L in the control group and (2.06±0.41)mmol/L in the observa-tion group,respectively;the GSH-Px activity was (197.23±18.73)U in the control group and (151.35±19.67)U in the observa-tion group,the differences between the two groups were statistically significant (P <0.05).Conclusion The decrease of serum se-lenium level and GSH-Px activity may be one of the pathogenic causes of GDM.

BACKGROUND: Various artifacts are found to be appeared in the nuclear magnetic resonance; the frequently appearing ones are the motion artifacts, plait artifacts, metallic artifacts, partial volume effect artifacts, chemical shift artifacts, phase artifacts, zipper artifacts and so on. However, there is still has no report on the controlling and revising method of the zipper artifacts which is produced in the spin-echo sequence imaging process. OBJECTIVE: Based on the discussion of the mechanism of the production of zipper artifact in the spin-echo sequence imaging process, a new impulse sequence is worked out to avoid the zipper artifact. METHODS: Standard SE sequence was complied to obtain the standard image, and compiling the artifact sequence to obtain the linear disturbance image and zipper artifact image, compiling the modified sequence to obtain the modified zipper artifact image. RESULTS AND CONCLUSION: Usually, the linear disturbance image could obtained in the instantaneous gradient of 5 degree with the echo sequence of 120 degree, and the zipper artifact will be obtained in the instantaneous gradient of 90 degree with the echo sequence of 120 degree. Modified sequence instantaneous gradient of 90 degree with the echo sequence of 120 degree can completely eliminate zipper artifact. The interesting result obtained in this paper is that the zipper artifact can be totally avoided with this new impulse sequence.

Objective To detect the pain condition in patients with Parkinson's disease(PD) and explore the clinical significance.Methods From May 2007 to February 2008,pain was examined in 162 PD patients in Department of Neurology,West China Hospital,Sichuan University and in 135 healthy controls well matched for gender,age and education.Statistics analysis was employed according to gender,age,the form of morbility,early-onset PD or late-onset PD,duration and Hoehn-Yahr degree.Results The incidence of pain in PD patients(53.1%)was higher than that in the healthy controls(23.7%)(P