Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province,and put forward policy recommendations for the critical illness insurance and health poverty alleviation.Methods 535 patients with tumor and end-stage renal diseases in Wuhan,Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis.Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure.Results 83.9% of the patients held their medical costs as too high;84.6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure.Conclusions Poverty rate is high among patients of such patients.To reduce their financial burden,the government is recommended to cover more major diseases,enhance support for those of critical illness and improve the medical assistance system.

Objective To exPlore the efficacy of nutritional interVention in Patients with chronic obstructiVe Pulmonary disease (COPD) and malnutrition risks. Methods From Jan. ,2008 to Dec. ,2012,829 COPD Patients with NRS2002 score≥3 in Qinzhou Second PeoPle's HosPital were enrolled in this study. Patients were randomized into control grouP (254 cases) and treatment grouP (575 cases) by random numerical table of SPSS 13. 0 statistic software. Patients without contraindication to enteral nutrition were giVen enteral nutrition suPPort,while those with contraindication to enteral nutrition were giVen Parenteral nutrition suPPort. Patients in the treatment grouP receiVed intensiVe suPPort with fortified nutrition,whereas Patients in the control grouP receiVed routine nutrition treatment. All other treatment methods were the same between the two grouPs. TelePhone follow_uP lasted for 3 years in both grouPs after discharge. Patients in the treatment grouP with NRS2002 score≥3 were giVen guidance on nutrition food intake. No nutrition guide was giVen to the control grouP. Times of acute attack,times and duration of mechanical Ventilation,mortality rate,and NRS2002 score three years after the treatment were comPared between the two grouPs. Data were analyzed by multi_factor Logistic regression analysis to understand the nutritional factors of COPD Patients affecting their mortality rate. Results After 3 years of follow_uP,times of acute attack,times and duration of mechanical Ventilation were lower in the treatment grouP than in the control grouP. Mortality rate was significantly lower in the treatment grouP (0. 696%) than the control grouP (4. 724%). After treatment,NRS2002 score was PositiVely correlated with mortality rate of COPD Patients with malnutrition risks. Conclusion For the COPD Patients with malnutrition risks, actiVe nutritional interVention can imProVe their nutrition status ( lower NRS2002 score) ,increase the number of resPiratory muscles to alleViate anoxia,enhance cellular immune function, and thus imProVe their Prognosis.

ObjectiveTo screen out the two-component system associated with drug resistance of Mycobacterium tuberculosis by detecting the differential expression of two-component system regulator genes between multidrug resistant Mycobacterium tuberculosis strains and drug sensitive strains. MethodsTotal RNA of MTB was extracted from cultured MTB during the logarithmic phase in the 7H9 brook medium, and then its purity was identified. Reverse transcription was further completed. The expressing levels of TCS response regulators were quantified using SYBR Green I qRT-PCR, which aimed at finding the differential expressions between multidrug resistant strains and sensitive strains. Finally, all of differentially expressed TCS were screened out under the stress of INH, SM and LFA. Results Compared with sensitive strains,multidrug resistant strains of Rv0491, Rv3133c, Rv3143 and Rv3246c were up-regulated 1. 03, 7.11,3.48and 1.37 folds, respectively (t/t' =5. 623, -4. 196, -3. 559 and -3. 016, respectively, P ＜0. 01 ). The expressing level of other regulators had no statistical significance between muhidrug resistant strains and drug sensitive strains. Under the antibiotic pressure, the expression of Rv1027c, Rv3246c and Rv3143 showed significant changes compared with no antibiotic group. ConclusionRv3246c and Rv3143 may be associated with MTB drug resistance and the differentially expressed genes in multi-drug resistant strains may be used as potential drug targets against drug resistant tuberculosis.

Objective To investigate the role of autophagy in radiation-induced death response of human nasopharyngeal carcinoma cells.Methods MTT method was used to detect cell viability of CNE-2 cells in different time after irradiation.Clonogenic survival assay was used to evaluate the effect of autophagy inhibitor (chloroquine phosphate) and autophagy inductor (rapamycin) on radiosensitivity of nasopharyngeal carcinoma cells.Cell apoptosis was assessed by flow cytometry.The expressions of LC3 and P62 were measured with Western blot.Cell ultrastructural analysis was performed under an electron microscope.Results Irradiation with 10 Gy induced a massive accumulation of autophagosomes accompanied with up-regulation of LC3-Ⅱ expression in CNE-2 cells.Compared with radiation alone,chloroquine phosphate (CDP) enhanced radiosensitivity significantly by decreasing cell viability (F =25.88,P ＜ 0.05),autophagic ratio (F =105.15,P ＜ 0.05),and LC3-Ⅱ protein level(F =231.68,P ＜0.05),while up-regulating the expression of P62 (F =117.52,P ＜ 0.05).Inhibition of autophagy increased radiation-induced apoptosis (F =143.72,P ＜ 0.05).Rapamycin (RAPA) also significantly decreased cell viability,but increased autophagic ratio and LC3-Ⅱ protein level while down-regulated the expression of P62.Induction of autophagy increased radiation-induced apoptosis(F =167.32,P ＜ 0.05).Conclusions Blockage of autophagy with CDP could enhance radiosensitivity in human nasopharyngeal carcinoma cells,suggesting that inhibition of autophagy could be used as an adjuvant treatment to nasopharyngeal carcinoma.

0.05),PaO2,PaCO2 of patient and to shorten the number of application days in intensified group were better than in routine group.The improvement of nutritional status in intensified group was also superior to routine group.There was significant difference between 2 groups (P

Objective To apply color Doppler flow imaging (CDFI) and transcranial Doppler (TCD) to the follow-up observation of the changes of cervical vessel,intracranial hemodynamics and cerebrovascular reserve capacity (CVR) of the patients after carotid artery stent implantation.Methods Totally 96 patients with carotid artery stent implantation underwent CDFI and TCD examinations,and the changes of hemodynamics were compared before and 1 month,6 months,1 a and 2 a after implantation.Results The values of peak systolic velocity (PSV) and resistance index (RI) at the areas of carotid stenosis were lower significantly than those before implantation,while the values of PSV,pulsatility index (PI) and CVR of the middle cerebral artery were obviously higher than those before implantation (P＜0.05).There were no significant differences between the cervical and intracranial hemodynamics indexes 1 month,6 months,1 a and 2 a after treatment.Two-year follow-up found 4 cases of restenoses after implantation,and the rate for restenosis was 4.2％.Conclusion Carotid artery stent implantation improves significantly cervical and intracranial blood supply as well as CVR of the carotid stenosis patient,and CDFI combined with TCD can be used for the accurate evaluation of the efficacy and postoperative follow-up of carotid artery stent implantation.

Objective To confirm the distribution of high arsenic drinking water and the situation of endemic arsenism in Hubei Province, to provide reference basis for prevention and control of endemic arsenic disease. Methods Using typical investigation and sample investigation in 2006 and 2007, the arsenic content of water was detected sampled from 19 counties(cities or communities). And those water samples which were close to or exceeded the stipulated standard were rechecked by the national standard method. Furthermore, the situation of endemic arsenism was investigated in the cities having high arsenic contents of water. Results In 2006,10 028 water samples of 446 villages in 6 counties (cities or communities) were tested, the wells of high arsenic (> 0.05 mg/L) were found in 5 counties (cities or communities) and the proportion of the well that exceeded stipulated standard was 5.29%(530/10 028); In 2007,19 086 water samples of 1282 villages in 17 counties(cities or communities) were tested, the wells of high arsenic were found in 11 counties(cities or communities), and the proportion of the well that exceeded stipulated standard was 1.74%(333/19 086). In these two years, 29 114 water samples were tested, in which 863 water samples were exceeding the stipulated standard. The 2.96% of total wells exceeded stipulated standard and mainly distributed in 179 villages of 12 counties(cities or communities). And the highest arsenic content of water sample was 2.012 mg/L. In the endemic arsenism area, 2 critical, 1 moderate and 1 mild arsenism patients had been found. Conclusions The water of high arsenic content are scattered in Hubei Province and the situation of endemic arsenism disease is mild. Improving water aiming at decreasing arsenic and establishing patient files should be carried out immediately.

OBJECTIVETo observe the protective effect and mechanism of Fufang Tangshang Gao (FFTSG) on deep grade II burn wounds in rats.

METHODThe deep grade II skin burn model was established. FFTSG was adopted for wounds once everyday for 21 d. Samples were collected at different time points after burn to determine the wound healing rate, the wound tissues water content, VEGF, TNF-alpha and IL-1.

RESULTAt different time points, FFTSG (0.4, 0.2, 0.1 g x g(-1)) could increase the wound healing rate and VEGF content and decrease the tissues water content, TNF-alpha and IL-1.

CONCLUSIONFFTSG shows a notable protective effect on deep grade II burn wounds in rats by obviously promoting the wound healing and decreasing the wound tissues water content. Its mechanisms may be related with the increase in VEGF synthesis and release of wound tissues and the decrease in TNF-alpha and IL-1 in rat blood serum.

Animals ; Burns ; drug therapy ; physiopathology ; Interleukin-1 ; blood ; Medicine, Chinese Traditional ; Neutrophils ; physiology ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; blood ; Vascular Endothelial Growth Factor A ; antagonists & inhibitors ; Wound Healing ; drug effects

Objective To evaluate the values of bilateral inferior petrosal sinus sampling ( BIPSS),high dosage dexamethasone suppression test (HDDST) and pituitary image in the differential diagnosis of ACTH-dependent Cushing's syndrome. Methods Totally 87 patients with confirmed pathological diagnosis were recruited in the study.All received the procedure of BLPSS,HDDST,and pituitary MRI with dynamic enhancement.The diagnostic performances of three differential diagnosis methods in ACTH-dependent Cushing's syndrome were evaluated.Results Seventy-eight patients were diagnosed as cases of pituitary ACTH adenoma,and the remaining 9 were confirmed cases of ectopic ACTH syndrome due to the thymic carcinoid.The sensitivity and specificity of HDDST,pituitary MRI,and BIPSS for the diagnosis of ACTH-dependent Cushing's syndrome were 82.1％ and 100％,79.5％ and 44.4％,92.3％ and 100％,respectively.In Cushing's disease,the diagnostic accuracy was 83.9％ with HDDST,77.0％with pituitary MRI,and93.1％ with BIPSS.In those patients with Cushing's disease,the coincidence of lateralization was 83.9％ with BIPSS and 64.5％ with MRII.Conclusion BIPSS was better than the other two methods in differential diagnosis of ACTH-dependent Cushing's syndrome.Compared with the pituitary MRI,the concordant rate of BIPSS in lateralization of the tumor is higher,and it is more reliable.

Objective The purpose of this study was to investigate the value of serum galactomannan (GM) in the diagnosis of invasive pulmonary aspergillosis (IPA) in patients with chronic obstructive pulmonary disease (COPD).Methods We enrolled 60 COPD patients in the study, including 19 IPA and 41 non-IPA cases.We examined serum GM of the patients by ELISA, evaluate the value of serum GM test for the diagnosis of IPA in patients with COPD, and compared the GM values before and after treatment.Results With 0.5 as the positive cutoff value, the sensitivity, specificity, positive predictive value, and negative predictive value of serum GM were 57.9%, 95.3%, 84.6%, and 83.0%, respectively, with a high specificity and a low sensitivity.The 7 IPA cases showed a significantly decreased GM value after treatment as compared with the baseline (0.30±0.21 vs 1.48±1.37, P=0.004).Conclusion The serum GM test has a limited value in the diagnosis of IPA in patients with COPD, but dynamic monitoring of the changes of the serum GM value may help evaluate the patient's condition.