Objective Probing into the changes of medical expenses by medical institutions for references to harnessing such expenses.Methods By means of the time sequence method,analyzing the dynamic changes of medical expenses of district of Beijing from 2004 to 2007,with a comparison for hospitals by levels.Results The study found that between 2004 and 2007,the medical expense per person of outpatients in 26 hospitals fell from 72.73 yuan to 70.09,with a relative ratio with a fixed base being-3.64%;the hospitalization expense per capital rose to 3044.35 yuan,with the same ratio being 13.15%;the percentage of pharmaceuticals sales among total income fell from 40.56% to 40.03%.Conclusions It is feasible to harness the rapid growth of medical expenses by means of normalizing medical charges,restricting the percentage of pharmaceuticals among total expense,improving hospital services at all levels,and promoting health education and health itself.

Objective To evaluate diagnostic value of diffusion tensor imaging(DTI)in ringlike- enhanced lesions.Methods Nine abscesses,12 glioblastomas,10 metastases confirmed clinically or pathologically underwent conventional MRI and DTI.Average diffusion coefficient(ADC)value,fractional anisotropy(FA)value and maps were calculated in the central portion and peripheral edema of the lesions. Results On DTI,the abscesses displayed as hyperintense signal with hypointense or isointense signal of edema;but glioblastomas and metastases all showed as hypointense signal with isointense or hypointense signal of edema.On ADC map,the abscesses showed as hypointense signal,the mean ADC value was (0.66?0.07)x10~(-3)mm~2/s,The mean ADC value were(2.50?0.11)x10~(-3)mm~2/s and(2.37?0.52)x10~(-3)mm~2/s for the glioblastomas and metastases,respectively,all demonstrated as hyperintense signal with slightly hyperintense signal of edema.The difference between abscess and necrotic tumors was statistically significant(F=108.80,P

The aim of this study is to observe the therapeutic effect of recombinant murine interleukin 12 (rmIL-12) combining with granulocyte colony stimulating factor (G-CSF) on mice irradiated by γ-rays. 56 BALB/c mice were totally irradiated by 6.0 Gy of (60)Co γ-ray and randomly divided into irradiation control group, rmIL-12 treatment group, G-CSF treatment group and combination therapy (rmIL-12 plus G-CSF) group. rmIL-12 20 µg/kg was administrated intraperitoneally at 1 h following irradiation, and was administrated every 3 days after irradiation for 4 times in rmIL-12 treatment group. G-CSF 100 µg/kg was administrated subcutaneously the 2 h following irradiation for 14 d in G-CSF treatment group. The dose and method of rmIL-12 and G-CSF in combination therapy group were same as in rmIL-12 group and G-CSF group. The general status of mice were observed twice a day, the changes in body weight, peripheral blood cell (WBC and Plt) counts were examined once every three days, bone marrow cells were collected to perform colony cultivation on day 14 and 28 after irradiation. The results showed that WBC count recovery time in combination therapy group was significantly earlier than that of the control group (7 d vs 11 d), WBC count recovery velocity in the combination therapy group was no significant different from that of the G-CSF treatment group. Combined therapy significantly promoted Plt count recovery, resulting in less profound nadirs (16.5% vs 8.1%, P < 0.01) and rapid recovery to normal levels (11 d vs 14 d), Plt count recovery velocity in the combination therapy group was no significant different from that of the rmIL-12 treatment group. Culture of bone marrow cells in semi-solid medium also demonstrated that combination of rmIL-12 and G-CSF could stimulate bone marrow cells to form more CFU-GM and CFU-Mix than those of the irradiation control group in vitro on day 14 and 28 after irradiation (P < 0.05). It is concluded that the combination of rmIL-12 and G-CSF can significantly accelerate the recovery of hematopoietic function in mice with acute radiation sickness.
Animals ; Gamma Rays ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Interleukin-12 ; therapeutic use ; Male ; Mice ; Mice, Inbred BALB C ; Radiation Injuries ; drug therapy ; Radiation Injuries, Experimental ; drug therapy ; Recombinant Proteins ; therapeutic use

Objective:The anti-FⅩa assay can be used to monitor the blood concentration of Rivaroxaban. The aim is to evaluate the critical value and diagnostic performance of this test on bleeding risk assessment.Methods:From September 2017 to June 2019, 368 patients were enrolled for retrospective cohort study, including 201 males and 167 females, aged (62.8±15.7) years old. They were divided into groups by age:≤60 years old group 105 cases,61-70 years old group 135 cases,≥71 years old group 128 cases. Anti-FⅩa was detected on ACL TOP 700 coagulation analyzer using chromogenic substrate method to quantitatively determine the plasma concentration of rivaroxaban. Anti-FⅩa data were expressed as M ( P25- P75);Kruskal-Wallis H test was used for comparison among groups; Mann-Whitney U test was for data comparison between two groups; positive rate comparison was performed by χ 2 test; the diagnostic performance of anti-FⅩa to assess bleeding risk was evaluated by ROC curve;Kaplan-Meier curve was used for the survival analysis;the risk ratio (HR) was obtained by Cox proportional hazard regression model. Results:Both the peak and trough plasma concentrations were higher in patients aged 61-70 years old than ≤60 years old ( U values were 5 618 and 5 725,respectively, P values were 0.006 and 0.011, respectively); higher in patients ≥71 years old than 61-70 years old ( U values were 6 438 and 6 317, respectively, P values were<0.001).The incidence of bleeding events was higher in the 61-70 years old group than ≤60 years old group (χ 2=3.06, P<0.05),while not significantly different in the ≥71 years old group from 61-70 years old group (χ 2=0.35, P>0.05).Both peak and trough blood concentrations were higher in patients with bleeding than without bleeding(U values were 1 429 and 2 185, respectively, P<0.001 and 0.001, respectively).ROC showed that the cut-off values of peak blood concentration in evaluation of the overall and the ≥61 year-old population′s bleeding risk were 200.8 ng/ml and 209.9 ng/ml,respectively, corresponding respectively with the sensitivity of 90.9% and 95.0%; the trough cut-off values were 35.1 ng/ml and 39.1 ng/ml, respectively, corresponding respectively with the sensitivity of 72.7% and 70.0%. However, all the above cut-off values gave a low diagnostic specificity. Survival analysis showed with 35.1 ng/ml as the trough cut-off value, the cumulative risk of bleeding significantly increased in patients above the cut-off value (Log-rank χ 2=4.513, P=0.034). The Cox proportional regression model demonstrated that the hazard ratios for peak and trough blood concentration predictions of bleeding risk were 1.023 (95% CI: 0.834-1.256) and 0.948 (95% CI: 0.773-1.164). respectively. Conclusions:Both the peak and trough values of blood concentration in bleeding patients are higher than non-bleeding patients. The peak blood concentration is highly sensitive to the risk of bleeding, and the elevated trough blood concentration levels indicate that the probability of bleeding risk increases in the short term. However, the specificity of both peak and trough values is relatively low in bleeding risk assessment. When used alone, the prediction of bleeding events does not have direct guiding significance. Dynamic monitoring and joint evaluation are recommended.

The aim of this study was to investigate the radioprotective effect of recombinant murine interleukin 12 (rmIL-12) on mice irradiated by γ-ray. Fifty- six BALB/c mice were totally irradiated by 6.0 Gy of (60)Co γ-ray and randomly divided into irradiation control group,rmIL-12 treated group and recombinant murine thrombopoietin (rmTPO) treated group.The 5 and 20 µg/kg of rmIL-12 were administrated intraperitoneally at 24 h before irradiation respectively (low and high dose rmIL-12 treated group), 15 µg/kg of rmTPO was administrated subcutaneously at 30 min and 24 h following irradiation in rmTPO treated group. The general conditions of mice were observed twice a day, the changes in body weight and peripheral blood cell counts were examined once every three days, bone marrow cells were collected to perform colony cultivation at day 14 and 28 after irradiation. The results showed that the general conditions of mice in rmIL-12 treated group were better than those in irradiation control group. Compared with the irradiation control group,5 and 20 µg/kg rmIL-12 treatment significantly promoted platelet recovery, resulting in less profound nadirs (15.9% vs 8.1%,18.2% vs 8.1%,P < 0.01) and rapid recovery to normal levels (11 days vs 14 days). WBC count recovery rate in rmIL-12 treated group was faster than that in the irradiation control group. The WBC and platelet count recovery rate in 5 µg/kg rmIL-12 treated group were as fast as that in the rmTPO treated group, both of which were slower than that in 20 µg/kg rmIL-12 treated group (P > 0.05). Semi-solid bone marrow cell culture also demonstrated that rmIL-12 could stimulate bone marrow cells to form more CFU-Mix than those in the irradiation control group in vitro at day 14 and 28 after irradiation(P < 0.01).There was no significant difference between rmIL-12 and rmTPO treated groups (P > 0.05), CFU-GM counts in 5 µg/kg rmIL-12 treated group and rmTPO treated group at day 28 after irradiation were higher than those in irradiation control group(P < 0.05), but less than those in 20 µg/kg rmIL-12 treated group (P < 0.05). It is concluded that rmIL-12 has a significant radioprotective effect on mice irradiated by γ-ray.
Animals ; Blood Platelets ; Gamma Rays ; Interleukin-12 ; therapeutic use ; Male ; Mice ; Mice, Inbred BALB C ; Platelet Count ; Radiation Injuries, Experimental ; blood ; Radiation-Protective Agents ; therapeutic use ; Recombinant Proteins ; therapeutic use ; Thrombopoietin ; therapeutic use ; Whole-Body Irradiation

Objective To examine the impact of pregnancy termination before 28 weeks of gestation on the overall prevalence of neural tube defects (NTDs).Methods Data collected during the period of 2004 and 2010 from a birth defects surveillance system in Pingding county and Talgu county of Shanxi province were used.Number of births ≥28 weeks of gestation and number of cases with major birth defects among the births were collected.Terminations of pregnancies before 28 weeks of gestation due to prenatal diagnosis were also collected.The total prevalence of neural tube defects,prevalence before 28 weeks of gestation,and prevalenee of ≥28 weeks gestation were calculated using the total number of pregnancies of ≥28 weeks of gestation as denominator.The prevalence data were compared to examine the impact of pregnancy termination on the total prevalence.The proportions of pregnancy terminations before 28 weeks of gestation due to prenatal diagnosis of an NTD against the total number of NTD cases were also calculated.Results During 2004-2010,52 366 births were recorded,and 485 NTD cases were ascertained.The overall prevalence of NTDs was 92.6 per 10 000 births,with prevalence of ＜28 weeks gestation due to pregnancy terminations as 60.9 per 10 000 births,while the prevalence of ≥28 weeks of gestation was 31.7 per 10 000 births.NTD prevalence of ≥28 weeks gestation was 66.0％ lower than the total NTD prevalence.In the last two years,the proportion of NTDs ascertained ≥28 weeks gestation accounted for about 40.0％ of the total NTD cases.Conclusion A birth-defect-surveillance program that covered only tregnancies ≥28 weeks of gestation resulted in a severe underestimation of the total birth prevalence of NTDs,especially for anencephaly.We would recommend that the current national birth defects surveillance system should include pregnancy terminations before 28 weeks of gestation and the calculation of total NTD prevalence should also include these cases into the numerator,so as to better estimate true population NTD prevalence,upon which the related public health policy is based.

OBJECTIVETo study the prevalence rates of birth defects in high and low risk areas in China.

METHODSA population-based surveillance system on birth defects was used to obtain the prevalence rates of 24 kinds of major external birth defects from > or = 20 weeks of gestation to 7 days of life in selected areas in Shanxi and Jiangsu provinces.

RESULTSThe birth prevalence of birth defects (232.4 per 10,000 births) and neural tube defects (NTDs) (138.7 per 10,000 births) in four counties of Shanxi province were significantly higher than that in Taiyuan city (75.3 and 28.2 per 10,000 births, respectively). There was no significant difference for all selected birth defects between Wuxi city and Xishan counties in low risk areas. There was a 6.1-fold of higher prevalence for NTDs in Taiyuan city compared with that in Wuxi areas (4.6 per 10,000 births). In four counties of Shanxi province, the prevalence rates of anencephaly, spina bifida, hydrocephaly, cleft palate alone and polydactyly were significantly higher than in Wuxi areas. The NTDs prevalence rate in four counties of Shanxi was 30.2 times higher than in Wuxi areas. When compared with previous surveillance data, the NTDs prevalence rate did not present obvious declining trend in high risk areas. The birth prevalence rate had a 31.8% decrease when births were calculated after 28 gestational weeks and compared with those from 20 gestational weeks.

CONCLUSIONNTDs remained to be the most common birth defect seen in Shanxi province. The birth prevalence rate of NTDs in some areas of Shanxi province was among the highest that ever reported in the world in comparison with data from other countries and regions. The current prevalence rate in high risk areas in Shanxi province did not clearly show a declining trend. Programs on surveillance and prenatal diagnosis were proved to have made big impact on the rates of major external birth defects.

China ; epidemiology ; Congenital Abnormalities ; epidemiology ; Female ; Humans ; Male ; Neural Tube Defects ; epidemiology ; Prevalence ; Surveys and Questionnaires