Objective:To put forward rational suggestions of how to reduce the protest in medical insurance cases from two aspects:hospitals and medical insurance agencies, to provide reference for strengthen management of designated hospitals and Medical Insurance Center. Methods:Taking a tertiary hospital of Beijing as an example, summarizing the basic situation of protest in medical insurance and analyzing several kinds of cases, making thorough analysis of deep-seated reasons which caused the protest in medical insurance and finally put forward rational suggestions. Results: The protest in medical insurance is not only caused by hospitals, the Medical Insurance Center should also take certain responsibilities. Conclusion: Hospitals and Medical Insurance Center should all take corresponding measures to reduce the protest in medical insurance cases.

Objective To investigate the mental health and personality of soldiers operated inside and outside tunnels,and explore the necessity and particularity of mental training.Method One hundred and four soldiers worked inside tunnel and 88 outside tunnel were tested by Symptom Checklist 90(SCL-90) and Eysenck personality questionnaire(EPQ),and the results were analyzed statistically.Result With an exception of phobia,the SCL-90 scores of most factors were significantly higher in the soldiers worked inside tunnel than outside tunnel(P0.05) on EPQ-E and EPQ-P scores.Some of SCL-90 index scores showed positive correlation with EPQ-P and N dimension scores,and negative correlation with EPQ-E dimension score(P0.05).Conclusion Personality feature is an important factor that influences the mental health of soldiers worked inside tunnel.It is important to adopt appropriate mental training and improve the adaptability of soldiers to the military environment.

Objective To investigate the changes of serum protein profile of rats in psychological stress and in analogous psychological training,identify the differential expression proteins,and assess the effectiveness of psychological training.Methods Thirty-two male Wistar rats were randomly divided into psychological training group,psychological stress group,control group and stressor group (8 each).Rats in stressor group received intermittent foot-shock.Instead of foot-shock,the rats in psychological stress group animals received the stimulation information from stressor group by watching,listening and smelling.Rats in psychological training group were put in special equipment and received stimulation information from stressor group synchronously,and in control group were kept in individual cages and received no stress.Experiments were performed once a morning for two weeks.The changes of serum protein profile of rats in psychological training group,psychological stress group and control group were determined and statistically analyzed by Surface Enhanced Laser Desorption Ionization-Time of Flight-Mass Spectrometry (SELDI-TOF-MS) after the experiments.Results Variance analysis showed that the relative contents of proteins with M/Z value of 7820.51,8870.18,6860.85,8625.13 and 11413.91Da were significantly different (P

Biliary atresia (BA) is one of the most serious pediatric surgical digestive system diseases with progressive liv?er bile duct inflammation and fibrous obstruction. Currently, the etiology of BA is not clear. It may be associated with genetic predisposition, viral infections and immune injury. Now many scholars believe that it was resulted from multiple factors. Among them, the theory of immune-inflammatory is supported by most scholars. Now the mechanisms of CD38, CD138 and IgG4 in autoimmune liver disease were reported in literature. BA and other autoimmune liver diseases are similar in terms that both inflammatory and immune responses plays irreplaceable role during disease development. Therefore, this article briefly review the role of CD38, CD138 and IgG4 in the inflammation-immunity of BA.

Anniversaries and Special Events ; China ; Humans ; Public Health ; Security Measures ; Sports

AIM: To investigate the clinical safety and effectiveness of the two kind of bandage contact lenses: Senofilcon A (Johnson & Johnson Acuvue Oasys) and Balafilcon A ( Bausch& Lomb pure vision ) after laser - assisted subepithelial keratectomy (LASEK).
METHODS: Thirty - eight patients (76 eyes) who had undergone the LASEK were divided into two groups. One group of patients wore Balafilcon A, the other group of patients fitted with Senofilcon A. The lenses were worn continuously for 7d. This was a seven - day experience and the patients scored for the symptom of the eyes (sore eyes, foreign body sensation and tearing) on the third day and the seventh day. Both of the two groups of patients taken off the soft contact lens on the seventh day and let their vision and corneal staining checked.
RESULTS: The symptoms of eye sore and tearing of the two groups patients were different. The patients who wore the Senofilcon A were better. The pain of eyes were also different at 3 and 7d after surgeries(Z = - 4. 146, P =0. 000; Z= - 2. 814, P = 0. 005). The difference on tearing between the two groups at 3 and 7d after surgeries were significant ( Z = -2. 309, P = 0. 021; Z= -3. 276, P= 0. 001). There was no difference on sensation of dryness between the two groups at 3 and 7d after surgeries (Z= -0. 447, P=0. 655; Z= -0. 966, P = 0. 334). After the lenses were taken off, the visual acuity of patients wearing Senofilcon A was better ( t = 3. 800, P = 0. 001 ); corneal staining showed limited spots in 1- 2 quadrants with significant difference (Z= -2. 384,P= 0. 017).
CONCLUSION: The Senofilcon A ( Johnson &Johnson Acuvue Oasys ) and Balafilcon A ( Bausch& Lomb pure vision) bandage contact lenses are safe and effective after LASEK, and the former is better than the latter in epithelial regeneration.

Objective: To investigate the biological behavior and prognosis factors of type B3 thymoma, and evaluate the efficacy of radiotherapy in patients with type B3 thymoma. Methods: A total of 188 consecutive patients with pathologically confirmed type B3 thymoma were treated in Shanghai Chest Hospital from January 2001 to December 2010. According to Masaoka stageing criteria, 35 (20%) were stage, 20 (11%) were stage, 78 (44%) were stage, and 44 (25%) were stage. Myasthenia gravis coexisted in 54 patients. Results: After a median follow-up of 49 months (7-135 months), the 5-year overall survival rate was 84% (100.0%, 89.0%, 86.1% and 59.8% of stages and respectively), and the 5-year progression-free survival rate was 65% (100.0%, 94.0%, 67.3%, and 33.0% of stages, and respectively).The reccurence rate was 22% and the metastatic rate was 7%. In the univariate analysis, tumor size, Masaoka stage, resection margin, radiotherapy and chemotherapy were significantly associated with 5-year overall survival and progression-free survival (P < 0.05). In the multivariate analysis, Masaoka stage, resection margin and radiotherapy were independent prognostic factors of 5-year progression-free survival (P < 0.05). Radiotherapy could improve the regional control rate and the overall survival of Masaoka stages ?-? patients. The intensity-modulated radiation therapy of pleure could probably improve the overall survival of recurrent patients. Conclusion: The major failure mode for type B3 thymoma is the recurrence of pleure. Radiotherapy can improve the regional control rate and the overall survival of the advanced patients. The intensity-modulated radiation therapy may be the best therapy for the postoperative recurrence of pleure. Copyright © 2013 by TUMOR.

OBJECTIVE: To study the application of isokinetic muscle testing in identification of the faked paralysis to provide scientific data for establishing a standard system of muscle strength in forensic medicine identification. METHODS: Fifty-seven patients with bone fracture or nerve damage as damaged group and 128 normal subjects pretended paralysis as faked paralyzed group were included in this study. Isokinetic muscle testing was performed on bilateral knees of all subjects in the two groups. The peak torque (PT) and peak torque angle (PTA) were compared between both sides in each group. The features of torque-time graph of two groups were classified. RESULTS: In the damaged group, the differences of PT between two sides of flexors and extensors were statistically significant (P<0.05), while the dif- ferences of PTA were not statistically significant (P>0.05). In faked paralyzed group, the differences of PT and PTA between two sides of flexors and extensors were both statistically significant (P<0.05). The torque-time graph of damaged knee presented mostly as single lead peak, while torque-time graph of the faked paralyzed knee presented mostly as multiple peaks. CONCLUSION The feature of torque-time graph could be useful to identify the faked paralyzed extremities in forensic authentication.
Case-Control Studies ; Humans ; Knee Joint/physiopathology* ; Male ; Muscle Strength ; Muscle, Skeletal/physiopathology* ; Muscles ; Torque

Objective To explore clinical diagnosis and surgical treatment for the traumatic liver rupture.Methods The clinical data of 60 cases with traumatic liver rupture were retrospectively cralyzed to explore the diagnosis and surgical treatment.Results 45 injury patients were diagmosed by,patient history,signs and imaging studies.15 cases of blunt injury,five cases diagnosed by above methods,10 cases of diagnostic peritoneal puncture are positive diagnosis.28 cases received the left hepatic lobe partial resection,20 cases right lobe partial resection,12 cases had the left hepatic lobe and right lobe partial nephrectomy.Among 60 patients,5 cases(8.33％) were dead and the other 55 patients,8 cases occured postoperative complications,were discharged after symptomatic treatment,the average length of stay was (15.6 ± 3.5) days.Conclusion Traumatic liver rupture is a critical illness,rapid and correct diagnosis before surgery,and choose the correct surgical approach,focusing on merger deal with injuries to postoperative complications,and improve the treatment success rate.

Objective To compare the abnormal influence of Ureaplasma urealyticum(UU) and human papillomavirus(HPV) infection on early pregnant women,and to investigate the correlation between reproductive tract infection with spontaneous abortion in early pregnant women.Methods A total of 460 pregnant women were included in the observation subjects,including 230 cases of spontaneous abortion (observation group) and other 230 normal pregnant women of delivery as the control group.The cervical swab samples were collected from the research subjects of the two groups and performed the UU and different types of HPV detections by using corresponding PCR reaction reagents.Results The UU total infection rate among 460 pregnant women was 17.83%(82/460),which of the observation group was 24.8%(57/230) and which the control group was only 10.9%(25/230),the difference between the two groups was statistically significant(P<0.01).The HPV total infection rate was 20.2%(93/460),which of the observation group was 29.1%(67/230) and which of the control group was only 11.3%(26/230),the difference was statistically significant.Among them,the single subtype HPV infection proportion was 14.1%(65/460),the multiple subtype HPV mixed infection proportion was 6.1%(28/460),while the high risk type HPV infection rate was 18.3%(84/460) and the low risk type HPV infection rate was 8.91%(41/460).The infection rate of UU combined HPV was 2.6%(12/460),in which the observation had 11 case and control group had 1 case,the difference was statistically significant (P<0.01).Conclusion Infection of UU and HPV in early pregnant women may lead to spontaneous abortion.But its concrete mechanism and the role of different types of HPV need to be further studied.