Objective To probe into a doctor-seeking medical management model for China's urban hypertension patients under medical insurance, and enhance the level and quality of medical insurance management. Methods Hypertension patients were surveyed with a structured questionnaire, and the staff at community health centers and medical insurance management centers received qualitative interview. Results The hypertension patients are found to see doctors mostly at community health centers and tertiary hospitals; complaints among hypertension patients for existing medical insurance vary with their areas, mostly targeting on complicated reimbursement procedure, high threshold of medical insurance payment and low level of reimbursement. Recommendation Experiment with the single-disease payment for hypertension, with the total prepayment in per capita and per disease; greater efforts in hypertension control in communities, with more favorable medical insurance policies for communities;elevated collaboration with medical institutions at all levels, and building and standardizing the management information network for hypertension patients.

Objective To investigate the characteristics and influencing factors leading to sudden cardiac death (SCD) of incarcerated prisoners. Methods Seventy-five SCD cases of prisoners between 2000 and 2013 in Henan province were collected, and environment, psychological and physical factors were retro-spectively analyzed. Combined with histopathological results, specific factors of SCD were also studied. Results In the 75 cases, 21 cases (28%) had definite chronic past medical histories, and 75 cases (100%) had cardiovascular disease confirmed by autopsy. Conclusion Due to presence of the potential cardiac diseases, special incarcerated environment, psychological stress, and body-restraint might be the precipitat-ing factors in SCD of those prisoners.

Objective To observe the effect of hydrogen-rich water on the CD34 expression and angiogenesis in lesion boundary brain tissue of rats with traumatic brain injury (TBI).Methods A total of 54 adult male SpragueDawley (SD) rats were divided into three groups by random number table:namely sham-operated group (sham group),trauma group (TBI group),and trauma + hydrogen-rich water group (TBI+HW group),the rats in each group were subdivided into 1,3 and 7 days subgroups according to the time points after trauma,with 6 rats in each subgroup.The TBI model was reproduced by using a modified Feency method for free fall impact,and the rats in sham group were not given brain impact after craniotomy.The rats in TBI+HW group were given intraperitoneal injection of hydrogen-rich water (5 mL/kg) after TBI model reproduction,and then once a day until being sacrificed,and the rats in sham group and TBI group were given the same amount of normal saline.The neurological severity scores (NSS) for neurologic deficits were calculated at corresponding time points,and then the rats were sacrificed for brain tissue at 3 mm around lesion boundary.After hematoxylin-eosin (HE) staining,the pathological changes in lesion boundary brain tissue were observed under light microscope.The expression of CD34+ cells was observed by immunohistochemical analysis,which markers were used to count the newborn blood capillary sprouts around the traumatic brain tissue.The protein expression of CD34was determined by Western Blot.Results NSS scores at all time points in sham group were 0.NSS scores in TBI and TBI+HW groups showed a decreased tendency with time prolongation after TBI,which showed more significant in TBI+HW group,NSS scores at 3 days and 7 days were significantly lower than those of TBI group (3 day:8.67 ± 0.52 vs.11.56 ± 1.94,7 days:7.33±0.52 vs.8.17±0.98,both P ＜ 0.05).Under light microscope,the brain tissue of rats in sham group was normal.After injury,pathological changes in lesion boundary brain tissue in TBI group were characterized by obvious hemorrhagic necrosis,severe brain edema,a large number of degeneration and necrosis of nerve cells and inflammatory cell infiltration,and the pathological changes were more obvious at 3 days.The edema area in TBI+HW group was slightly smaller than that of TBI group,and the surrounding edema was slightly reduced.It was shown by immunohistochemistry that only a very small number of neoformative capillaries were found in sham group.The number of neoformative capillaries in lesion boundary brain tissue was gradually increased with time prolongation in TBI group.The number of neoformative capillaries in TBI+HW group was more significantly,which was significantly higher than that of TBI group at 3 days and 7 days after injury (cells/HP:10.59 ± 1.88 vs.8.61 ± 1.22 at 3 days,23.20 ± 3.16 vs.17.01 ± 2.64 at 7 days,both P ＜ 0.05).It was shown by Western Blot that the expression of CD34 protein at all time points in TBI group was significantly increased as compared with that of sham group.The expression of CD34 protein at 1 day and 3 days in TBI+HW group was slightly increased as compared with that of TBI group without significant difference,but it was significantly up-regulated at 7 days after injury,which was significantly higher than that of TBI group (gray value:1.36 ± 0.36 vs.0.74±0.08,P ＜ 0.05).Conclusion Hydrogen-rich water promote CD34+ cells home to the site of injured tissue in rats with TBI,is involved in angiogenesis,and improve clinical outcomes during brain functional recovery.

Objective To discuss the expressions of VEGF ,EGFR and Smad4 in breast cancer tissue and their relationship with lymphatic metastasis .Methods 84 patients with breast cancer from June 2014 to June 2016 in our hospital were selected ,immuno-histochemical method was used to detect the expressions of VEGF ,EGFR and Smad4 ,and their relationship with lymphatic metas-tasis was analyzed .Results The positive expression rates of VEGF and EGFR were 22 .62% and 26 .19% respectively in breast cancer tissue ,which were notably higher than those in para-carcinoma tissue(22 .62% and 26 .19% respectively) ,and differences were statistically significant (P<0 .05) .Positive expression rate of Smad4 was 35 .71% in breast cancer tissue ,which was higher than that in para-carcinoma tissue(77 .38% ) ,and the difference was statistically significant (P< 0 .05) .The positive expression rates of EGFR and VEGF were 72 .92% and 70 .83% in Ⅲ + Ⅳ phase ,which were higher than those in Ⅰ + Ⅱ phase(50 .00% and 44 .44% ,respectively) ,differences were statistically significant(P<0 .05) .The positive expression of Smad2 was 25 .00% in Ⅲ +Ⅳphase ,which was lower than that in control group (50 .00% ) ,and the difference was statistically significant (P<0 .05) .The pos-itive expression rates of EGFR and VEGF were 77 .27% and 75 .00% in patients with lymphatic metastasis ,which were higher than those in patients without lymphatic metastasis (47 .50% and 42 .50% ) ,and differences were statistically significant (P< 0 .05) . The positive expression of Smad4 was 22 .73% in patients with lymphatic metastasis ,which was lower than that in patients without lymphatic metastasis (50 .00% ) ,and the difference was statistically significant (P<0 .05) .Pearson analysis showed that the posi-tive expression rates of EGFR and VEGF were positively associated with lymphatic metastasis (r1 =0 .382 ,r2 =0 .425 ,P<0 .05) , and the positive expression rate of Smad2 was negatively associated with lymphatic metastasis (r3 = -0 .468 ,P<0 .05) .Conclusion VEGF ,EGFR and Smad4 play an important role in the occurrence and development of breast cancer .The positive expression rates of EGFR and VEGF were positively associated with lymphatic metastasis ,and the positive expression rate of Smad2 was negatively associated with lymphatic metastasis ,which could have a guiding significance for prognosis of breast cancer .

ObjectiveTo systematically evaluate the efficacy and safety of Tianmeng Oral Liquid in the treatment of hyperprolactinemia caused by antipsychotics in female patients with schizophrenia， and to provide references for intervention of antipsychotic-induced hyperprolactinemia patients. MethodsEnglish databases （PubMed， Cochrane Library， PsycINFO and Embase） and Chinese databases （CNKI and Wanfang） were systematically searched， with a search time frame of the period from database creation to September 16， 2022. Randomized controlled studies （RCTs） on adjunctive Tianmeng Oral Liquid in the treatment of hyperprolactinemia caused by antipsychotics in female patients with schizophrenia were included. Three investigators independently screened the literatures and extracted data according to PICOS principles and evaluated the quality of including literatures， and the Meta-analysis was performed by using RevMan 5.3. ResultsA total of 3 articles including 256 female schizophrenic patients with hyperprolactinemia were included. Meta-analysis results showed that at the treatment endpoint， the improvement of hyperprolactinemia symptoms reported a significant superiority of the intervention group than the control group （RR=1.73， 95% CI： 1.07~2.79， P˂0.05）. Similarly， the significant superiority of the intervention group than the control group were also found in reducing serum prolactin levels （WMD=-55.17， 95% CI： -68.16~-42.18， P<0.01） and Positive and Negative Syndrome Scale （PANSS） total scores were lower in the intervention group than in the control group （WMD=-7.36， 95% CI： -8.94~-5.77， P<0.01）. ConclusionTianmeng Oral Liquid may help improve clinical efficacy and reduce serum prolactin levels in female schizophrenia patients with hyperprolactinemia. It may improve psychiatric symptoms in female patients with schizophrenia.