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.

AIM:To investigate efficacy of ranibizumab combined with laser treatment for patients with branch retinal vein occlusion (BRVO) and macular edema.METHODS: We selected 67 patients (67 eyes) with BRVO and macular edema in our hospital from March 2013 to June 2016, they were randomly divided into observation group (n=31) and control group (n=36).The observation group was treated with ranibizumab combined with laser treatment.The control group was treated with macular grid photocoagulation.We observed best corrected visual acuity (BCVA), centre macular thickness (CMT) and macular leakage of two groups.RESULTS: The BCVA of observation group at 1, 2 and 3mo after treatment were 0.41±0.07, 0.42±0.05 and 0.48±0.05, significantly higher than those of the control group (P<0.05).The CMT of observation group at 1, 2 and 3mo after treatment were 203.11±59.13μm, 201.41±56.22μm and 204.22±60.13μm, significantly lower than those of the control group (P<0.05).The blood vessel leakage of observation group at 3mo after treatment was significantly better than that of the control group (P<0.05).No leakage ratio in the observation group was 71%.There were no postoperative infection, aseptic endophthalmitis and other complications in the two groups.CONCLUSION: Ranibizumab combined with laser treatment in patients with BRVO and macular edema has better curative effect, can improve the visual acuity of patients, eliminate macular edema, and is safe and reliable.

In order to provide scientific basics for exploitation and sufficient application of Dendrobium officinale leaves resources, the phenol-sulfuric acid method was applied to determine the polysaccharide content. The monosaccharides were derivated by PMP and the derivatives were identified by HPLC-DAD-ESI-MS(n) and the contents of mannose and glucose were determined simultaneously. Similarity evaluation system for chromatographic fingerprint of traditional Chinese medicine (2004A) was employed to generate the mean chromatogram and similarity analysis of the samples was carried out. The results demonstrated that polysaccharide content, monosaccharide compositions and composition ratio had an obvious difference between stems and leaves. The polysaccharide content of stems was higher than that of leaves. Monosaccharide composition in leaf was significantly different from that in stem. The polysaccharide from stems was composed of mannose and glucose, however the polysaccharide of leaves was acid heteropolysaccharide and was mainly composed of five monosaccharides, including mannose, galacturonic acid, glucose, galactose and arabinose. The similarity value of the 14 batches was above 0.9, indicating that similarity of fingerprints among different samples was high. The study can provide evidence for expanding the medicinal parts of D. officinale.
Chromatography, High Pressure Liquid ; Dendrobium ; chemistry ; Mass Spectrometry ; Plant Extracts ; chemistry ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Polysaccharides ; chemistry

Objective To explore the feasibility of amide proton transfer (APT) MR imaging to detect cerebral abnormality of the substantia nigra and red nucleus in patients with Parkinson disease (PD). Methods Twenty-seven patients with PD and twenty-three age-matched healthy control subjects were recruited in this study. According to Hoehn&Yahr stages, PD group was divided into two subgroups:early-stage(n=14) and advanced-stage(n=13). PD with right limb onset were seen in 14 patients, and PD with left limb onset in 13 patients. All the PD patients and healthy controls underwent brain APT MR imaging. The magnetic resonance ratio asymmetry (MTRasym) values at 3.5 ppm of bilateral substantia nigra and red nucleus were measured on APT images. MTRasym(3.5 ppm)values of substantia nigra and red nucleus between PD patients and control subjects were compared with independent-samples t test. The difference of MTRasym(3.5 ppm)among normal controls, early-stage PD, and advanced-stage PD patients was assessed with one-way analysis of variance. Paired-samples t test was used to compare the difference of MTRasym (3.5 ppm) in substantia nigra and red nucleus between the side of onset and contralateral side in PD patients. Results Compared to normal controls, MTRasym(3.5 ppm) values of substantia nigra significantly decreased in PD patients[(0.96±0.35)%vs. (1.20±0.39)%respectively, t=-2.093 P=0.039]. No significant differences in MTRasym (3.5 ppm) values of red nucleus were observed between normal controls and PD patients[(0.97 ± 0.36)% vs. (1.09 ± 0.38)% respectively, t=-1.148, P=0.254]. Significant differences in MTRasym(3.5ppm) values of these cerebral structures were observed among normal controls, early-stage PD and advanced-stage PD [substantia nigra(1.20±0.30)%,(1.09±0.32)%and(0.81±0.37)%respectively, F=3.954, P=0.022;red nucleus(1.09±0.28)%,(1.21±0.35)%and(0.71±0.33)%respectively, F=7.563, P=0.001]. MTRasym(3.5 ppm) in substantia nigra showed a consistently decreasing tendency from normal controls to early-stage PD, to advanced-stage PD. MTRasym(3.5 ppm) values of sides of onset and contralateral sides of substantia nigra and red nucleus in PD patients had no significant statistically difference (substantia nigra(0.93 ± 0.33)% vs.(0.99 ± 0.30)%, t=-0.660, P=0.515; red nucleus(1.01 ± 0.36)% vs.(0.93 ± 0.29)%, t=0.545, P=0.590). Conclusions APT MR imaging can show sensitively the difference of MTRasym (3.5 ppm) in substantia nigra and red nucleus between early PD patients and normal controls, Thus, APT is a useful tool to diagnose PD and monitor the disease progression.

Objective To explore the feasibility of amide proton transfer (APT) MR imaging for the detection of basal ganglia abnormalities in patients with Parkinson' s disease (PD).Methods Twentyseven patients with PD and twenty-three age-matched normal control subjects underwent cerebral APT and structural MR imaging.The magnetic resonance ratio asymmetry (MTRasym) values at 3.5 ppm of bilateral globus pallidus,putamen and caudate were measured on APT images.MTRasym (3.5 ppm) values of cerebral structures between PD patients and control subjects were compared with independent-samples t test.Paired-samples t test was used to compare the difference of MTRasym (3.5 ppm) between the side of onset and contralateral side in patients with PD.The difference of MTRasym (3.5 ppm) among normal controls,early-stage PD,and advanced-stage PD patients was assessed with one-way analysis of variance.Results Compared to normal controls,MTRasym(3.5 ppm) values of globus pallidus,putamen and caudate were significantly increased in PD patients ((0.89 ±0.12)％ vs (0.57 ±0.16)％,(1.05 ± 0.11)％ vs (0.82 ± 0.15)％,(1.15 ±0.13)％ vs (0.78 ±0.19)％; t =3.311,2.562,3.277 respectively,all P values ＜ 0.05).Significant differences in MTRasym (3.5 ppm) values of these cerebral structures were observed among normal controls,early-stage PD and advanced-stage PD patients.And MTRasym (3.5 ppm) values in globus pallidus,putamen and caudate were significantly higher in early-stage PD patients than normal controls.In PD patients,even not statistically significant,MTRasym (3.5 ppm)values of sides of onset were slightly lower than contralateral sides.Conclusions APT MR imaging can sensitively identify the difference of MTRasym (3.5 ppm) in the basal ganglia between PD patients and normal controls.APT might be a useful tool to evaluate abnormal metabolite in basal ganglia of PD patients.

Objective To explore the clinical value of virtual touch quantification (VTQ) technique in assessing the hepatic fibrosis. Methods A total of 115 inpatients with chronic liver disease receiving liver biopsy were enrolled in this study, all patients liver tissue was checked by VTQ technique, and the results were compared with those of the control group including 80 healthy subjects. Results VTQ value was significantly different between the two groups (P = 0.0000).The VTQ value among different degree of hepatic fibrosis but between S0 and S1 had statistical significances (P = 0.0212, P = 0.0000).ROC curve displayed that VTQ value of 1.4 m/s could be used to diagnose middle-high-grade liver fibrosis, the sensitivity and specificity were 85.4 % and 64.7%, respectively. Conclusions VTQ can be used as a noninvasive and effective means for assessing the degree of hepatic fibrosis.

OBJECTIVETo investigate the occupational health condition in a shipyard in Guangzhou, China, and to provide a basis for improving the working environment.

METHODSThe monitoring data on occupational harmful factors in the workplace and the data on health examination of the workers were analyzed, and the occupational health condition in the shipyard was evaluated with the related occupational health standards.

RESULTSExcept benzene, toluene, and electromagnetic radiation, the dust (2.02%), grinding wheel dust (3.85%), wood dust (2 out of 4 workers exceeded the standard), welding fume (16.85%), manganese dioxide (17.98%), dimethylbenzene (8.00%), and noise (53.20%) were all out of limits to different degrees. The health examination results of 2450 workers in the shipyard showed that the respiratory impairment of dust-exposed workers (3.19%) and the hearing impairment of noise-exposed workers (12.21%) were comparatively severe.

CONCLUSIONThe occupational health condition in this shipyard is not good. In order to protect the workers from health hazards, it is urgent and necessary to improve the working environment and strengthen the personal protective measures.

Air Pollutants ; Benzene ; China ; Construction Industry ; Dust ; Humans ; Noise ; Occupational Diseases ; Occupational Exposure ; Occupational Health ; Ships ; Surveys and Questionnaires ; Welding ; Workplace

Objective To evaluate the outcomes of mature B-cell acute lymphoblastic leukemia(mature B-ALL) and to assess the safety and efficacy of the treatment protocol.Methods From February of 2003 to December of 2012,15 children were diagnosed as mature B-cell acute lymphoblastic leukemia/lymphoma possible (mature B-ALL/NHLp) in Shanghai Children's Medical Center(SCMC) were enrolled,and they were treated with SCMC-mature B-ALL/NHLp-2003 protocol.All of the clinical characteristics,therapeutic effects and long-term outcomes were analyzed.The statistical data were processed by SPSS 21.0.Results The median age on diagnosis was 8.7 years (1 year and 5 months to 14 years and 4 months).Among them,4 cases presented with local mass including maxillofacial tumors,neck and abdominal mass.The others had systemic manifestations such as fever and pale face.These neoplastic cells retained the expressions of surface membrane immunoglobulin M,terminal deoxynucleotidyl transferase,Cμ,CD10,CD19,cCD79 a differently.Follow-up was updated to November 30,2013.The median follow-up period was 80 months (39-128 months).Theestimated 5-year event free survival rate was (80.0 ± 10.3) ％.According to univariate analysis,increased lactate dehydrogenase level (＞ 4-times the normal value),increased serum ferritin level (＞ 2-times the normal value),no small residual disease markers were indepen-dent poor prognostic factors(x2 =5.49,4.89,5.49,all P ＜ 0.05).Conclusions SCMC-mature B-NHL/ALLp-2003 protocol is feasible and safe for children with mature B-ALL/NHLp,but more sample cases need to be investigated.