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.

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

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 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.

Objective To discuss the safety and efficacy of transcatheter arterial chemoembolization (TACE) in treating patients with inoperable hepatocellular carcinoma (HCC) who has a history of hepatic failure. Methods A total of 7 HCC patients who had a history of hepatic failure (study group) were enrolled in this study. TACE was carried out in all these 7 patients. Other 51 patients who had no liver failure history were used as the control group. All the patients were followed up for at least six months. The postoperative adverse events, changes of liver function and the prognosis were recorded, and the results were compared between the two groups. Results In the study group, neither treatment-related death nor severe adverse events occurred. No significant difference in the occurrence of mild adverse events existed between the two groups. After TACE the liver functions, including alanine aminotransferase, total bilirubin, prolonged prothrombin time, albumin, etc. in the study group were significantly worse than those in the control group,groups. Conclusion For patients with inoperable hepatocellular carcinoma who has a history of hepatic failure, TACE is a safe and effective treatment.

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 high risk factors of metabolic syndrome(MS) in obese children with acanthosis nigricans.Me-thods Body mass index(BMI),blood lipid including triglyeride(TG) and cholesterol(CHO),low density lipoprotein-cholesterol(LDL-C),blood pressure,the level of fasting blood glucose(FBG) and 2 h after oral glucose tolerance test blood glucose(OGTT 2h BG) and the level of fasting insulin(FINS) and 2 h after oral glucose tolerance test insulin (OGTT 2h INS) and homeostasis model appraisal insulin resis-tance index(HOMA-IR) were measured and compared between 25 obese children with acanthosis nigricans[male 15,female 10;aged 8.4-16.0,mean 10.6 years old,weight (72.11?17.66) kg;height (155?14) cm]and 32 normal healthy children[male 18,female 14;aged 7.6-15.8,mean 9.8 years old]in department of pediatric during 1 year.HOMA-IR were also analyzed.Ultrasonic inspections for liver were performed in those children.Results BMI,TG,LDL-C and blood pressure in the obese group were significantly higher than those in the normal control group(Pa0.05).Eighty-four percent of patients in obese children with acanthosis nigricans were diagnosed adiposis hepatica by ultrasonograph.Conclusions The increasing BMI,insulin resistance,blood lipid disorder and blood pressure increase in obese children with acanthosis nigricans are the high risk factors of MS,the close followed-up and treating this kind of obese children can acquire MS early and be helpful to postpone the progress of diabetesⅡ and cardiovascular diseases.