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.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Immunoglobulin D ; Male ; Middle Aged ; Multiple Myeloma ; classification ; pathology ; Retrospective Studies

One hundred patients underwent coronary artery bypass grafting and thirty patients underwent replacement of mitral valve were included in this study, and patients were randomized to two groups. Adenosine group (group I):6 mg adenosine was diluted with physiological saline and injected from the root of the ascending aorta after blocking it. The aorta was then perfused with high-potassium cold-blood cardioplegia. Control group (group II):the aorta was just perfused with high-potassium cold-blood cardioplegia. Adenosine was only added in first perfusion in adenosine group. Both groups were reperfused half-amount of cold-blood cardioplegia containing potassium every 30 minutes. Relevant clinical indexes and myocardial enzymological determination were compared between two groups. Results For patients who underwent CABG, the cardiac arrest induced time,ICU dwell and assisted ventilation time after surgery and dopamine usage were all less in adenosine group than those of control group (P < 0.05). There were no significant differences in the total number of cardioplegia of perfusion fluid, the total amount of perfusion, clamping aorta and assisting circulation times and automatic rebeating between two groups (P>0.05). For patients who underwent MVR, the cardiac arrest induced time and dopamine usage were all less in adenosine group than those of control group (P<0.05). There were no significant differences in times and total number of cardioplegia of perfusion fluid, clamping aorta and assisting circulation times, ICU dwell and assisted ventilation time after surgery automatic rebeating between two groups (P>0.05). For both operations, 4 hours after clamping aorta, creatine kinase isoenzyme (CK-MB) was less in adenosine group than that of control group (P<0.01 or P<0.05), and 4 hours and 24 hours after bypass, cardiac troponin I (cTnI) was significantly higher in control group than that of adenosine group (P < 0.05). Conclusion After aorta is clamped, immediate injection of adenosine diluent and cold-blood cardioplegia containing potassium from the root of the ascending aorta can lead to quick heart arrest, reduce the release of myocardial enzymes and dosage of vasoactive agents, and shorten ICU dwell and assisted ventilation time.

Objective To explore whether gastrointestinal carcinoma could influence differentiation and maturation of dentritic cell (DC) in cultured peripheral blood mononuclear cells (PBMC). Methods PBMC of peripheral blood obtained either from healthy individuals or gastrointestinal carcinoma patients were incubated to induce into DC with the aid of addition of GM-CSF, IL-4 and TNF-?. The percentage of DC and expression rate of markers CD83, CD1a were determined by flow cytometric analysis. Results The quantity of PBMC isolated from gastrointestinal carcinoma patients was less than that from healthy individuals with same volume of blood. DC could be induced from PBMC of gastrointestinal carcinoma patients, and they could express B7 costimulatory molecules as those of healthy individuals. But the expression rates of CD83, CD1a were significantly different in two groups. Conclusion The quantity of PBMC and their ability to differentiate into DC seemed to be decreased in gastrointestinal carcinoma patients.

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.

Purpose To investigate the expression of secreted frizzled-related protein 4 (SFRP4) and to evaluate its clinical significance in pancreatic ductal adenocarcinoma (PDAC).Methods RT-PCR was performed to analyze SFRP4 mRNA expression level in 30 paired PDAC lesion and matched adjacent non-tuimor tissue.Immunohistochemistry staining detection of 205 matched cases tissue microarray was conducted to explore SFRP4 protein expression pattern.The correlation between SFRP4 and clinical characteristics was also analyzed,including overall survival.Results SFRP4 expression pattern both at mRNA and protein level in PDAC lesion was higher than that in matched adjacent non-tumor tissue.At mRNA level,to found that expression of SFRP4 was elevated in 90％ (27/30) of PDAC tissues (P =0.007 2).To found that high expression of SFRP4 was detected in 56.5％ (116/205) of PDAC tissue,while only 28.8％ (59/205) in the adjacent non-tumor tissue.Moreover,no significant association was observed between SFRP4 expression and clinical characteristics.Kaplan-Meier survival analysis showed high level of SFRP4 expression was correlated with poor overall survival (x2 =3.467,P =0.024).Conclusion SFRP4 can be a novel prognostic biomarker in PDAC.