Objective To analyze the effect of different medical insurance payments on medical expenses so as to provide some suggestions for Guangdong Provincial Department of Offsite Medical Insurance Administration in its future policy-making.Methods An statistic analysis was conducted of medical expenses among patients who chose different medical insurance payments and their average length of stay.Results Medical expenses and average length of stay were statistically different among patients who chose different payments.Conclusion The medicare reimbursement′s inclusion of prevention and diagnosis should be recommended to establish a flexible referral system, reinforce the payments reform and increase the efficiency of social security funds.

AIM: To analyze the electronic product use time, writing time, playing piano time and outdoor activity time and the distribution of myopia in 586 cases of school age children in our hospital. ·METHODS: A retrospective analysis of 586 cases of children aged 6 to 12 years old in the outpatient department was established. Personalized files were used to record the uncorrected visual acuity, optometry, slit lamp, fundus mirror and strabismus. The cumulative use time of electronic products ( including computer, mobile phone, iPad) , writing time, whether to play the piano and outdoor activities time with the eye situation were recorded. Statistical analysis of the age group of myopia, the cumulative use of electronic age in different age groups, writing time, whether playing piano and outdoor activities and the distribution of myopia occurred. · RESULTS: ( 1 ) With the increasing of age, the distribution of uncorrected eyesight was in children mostly mild myopia, and the proportion of mild myopia was significantly higher than that of moderate and high myopia. ( 2 ) Electronic products use time distribution:the proportion of playing electronic products ( including mobilephone, computers, iPad) accounted for 76. 8%, of which 9 years old, 10 years old the cumulative use of electronic products with a long time was higher than other age groups. ( 3 ) Distribution of writing time: the proportion of write homework ≤1h was significantly lower than the proportion of writing homework > 1h (37. 2% vs 62. 8%), of which 9 and 10 years old children cumulative write time was higher than other age group. ( 4 ) Distribution of playing the piano: the proportion of playing piano time less than 1h was significantly higher than the proportion of playing piano time more than 1h ( 89. 1% vs 10. 9%). ( 5 ) Distribution of outdoor activities: the proportion of outdoor activities ≤1h in children at school age was significantly higher than that of outdoor activities > 1h (91. 8% vs 8. 9%). ·CONCLUSION: With the age exposure to electronic products becoming younger, heavy learning tasks and less outdoor activities, myopia occurred in advance of age. So health examination and eye guidance, reducing the amount of work appropriately, increasing outdoor activities will slow the development of early childhood myopia.

ObjectiveTo investigate current iodine nutritional status of different groups of people in Harbin city, and to provide the basis for development of salt iodization standard and scientific iodine supplementation.MethodsThree urban districts and three surrounding counties were chosen in Harbin,2011.In each chosen urban district and county,one district office (township) was selected,and one residents committee (village) was chosen in each of the district office(township),and 30 households were selected by systematic sampling.Iodized salt,water iodine and iodine intake per capita were investigated.In each of the residents committee (village),20 adults aged 18 - 45,30 pregnant women or lactating women,and 100 school children aged 8 - 10 were selected.Urine samples were collected and urinary iodine level were tested.Salt iodine was determined by direct titration,water and urinary iodine by arsenic cerium catalytic spectrophotometry.Iodine uptake and iodine nutritional status of different populations in Harbin urban and rural areas were compared.ResultsThe edible rate of qunlified iodized salt were 93.3％(84/90) and 96.3％(156/162) in Harbin urban and rural residents,respectively,which were all greater than 90％,and the highest value of salt iodine were 38.3,46.0 mg/kg,respectively,in urban and rural areas,which all did not exceed the upper limit(50 mg/kg) of qualified iodized salt,but there were some samples of salt iodine content below the national standard(20 mg/kg).Water iodine value in urban and rural areas,even the highest value(9.40,8.40 μg/L),was failed to meet the national standard 10 μg/L; salt eaten by rural people perperson a day(8.33 g) was significantly higher than that of the urban people(7.03 g,Z=- 2.750,P ＜ 0.01); in addition to rural children aged 8 - 10,whose urinary iodine value(228.6 μg/L) was higher,the values in urban and rural adults ( 111.3,195.6 μg/L),pregnant women ( 193.0,172.9 μg/L),lactating women ( 128.4,173.7 μg/L)and urban children ( 186.8 μg/L ) were all in appropriate level.The urinary iodine medians ( 195.6,228.6 μg/L )of adults and children in rural were significantly higher than that of urban adults and children(111.3,186.8 μg/L,Z =- 2.294,- 5.434,P ＜ 0.05 or ＜ 0.01,respectively).Population composition of iodine deficiency in both urban and rural adults,lactating and pregnant women[46.7％(28/60),21.6％(13/60) ; 21.1％(19/90),21.3％ (18/89) ; 27.8％ ( 25/90 ),42.2％ (38/90) ] were significantly higher than that of the population composition with iodine excess[4.6％(4/60),5.0％(3/60) ; 16.7％(15/90),16.9％(15/89) ; 4.4％(4/90),0.0％(0/90)],but proportion of iodine excessive population in rural children [26.3％(79/300)] was significantly higher than proportion of iodine deficiency[5.6％(17/300)].ConclusionsThe natural environment of Harbin city is still in the iodinedeficient state.In addition to children in rural areas,the iodine intake and iodine nutrition level is basically appropriate; the risk of disease caused by iodine deficiency in adults,lactating and pregnant women is higher than by iodine excess,but the situation of children in rural is on the opposite.Therefore,we should strengthen the monitoring of different populations,and supplement iodine scientifically based on their need.

The relationship between Ala/Ser polymorphism in 133 codon of exon 3 region of the RASSF1 gene and genetic susceptibility of lung cancer in Hubei province Han population was investigated by a case-control study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was adopted to analyze the polymorphism of codon 133 of exon 3 in the RASSF1 gene of 100 pathologically diagnosed lung cancer patients, and 100 healthy controls. The relationship between different genotypes and the susceptibility of lung cancer was analyzed. Among 200 blood samples from Han people in Hubei Province, including 100 from lung cancer patients and 100 from healthy controls, the frequencies of Ala/Ala, Ala/Ser, Ser/Ser genotype of the RASSF1 in lung cancer patients were 83%, 16%, 1%, and those in healthy controls was 93%, 7%, 0% respectively, with the difference being statistically significant between two groups (P<0.05). The individuals with Ala/Ser genotype had higher risk of suffering from lung cancer, with an OR of 2.341, and 95% CI of 1.009-6.393 respectively. It was concluded that RASSF1Ala133Ser was a susceptible genetic factor of lung cancer. Ala/Ser genotype increased the risk of lung cancer.

Age - related macular degeneration ( AMD ) is the leading cause of irreversible visual loss in elderly people among white - dominated population. At percent, treatment for AMD includes anti - vascular endothelial growth factor antibody ( Anti- VEGF ) drug treatment, photodynamic therapy ( PDT ) , topical application of triamcinolone acetonide ( TA ) and laser therapy ( nanosecond laser) etc. Through comparative analysis of different treatment methods of AMD, we review the mechanism, clinical efficacy, adverse events and cost effectiveness to provide the basis for clinical treatment.

Objective To assess the feasibility of double phase subtraction angiography with second generation (128-slice )dual-source CT in low dose Flash spiral scan mode for the evaluation of cerebral vessel,compared with dual-energy subtraction angiogra-phy.Methods 60 patients underwent double phrase CT angiography were divided into group A (n = 30,with Flash spiral scan mode),group B(n=30,with dual-energy scan mode).The signal-to-noise ratio(SNR),the contrast-to-noise ratio(CNR)and the av-erage radiation of double phrase subtraction images were measured in two groups,respectively.The double phase subtraction images quality were graded by 2 independent readers on a 5-point scale(5=excellent)in double-blind,according to various degrees of the re-sidual bones,the vessel displayed and luminal integrity,respectively.Differences between two groups were analyzed by Mann-whit-ney test and t test.Results The double phrase image SNR showed no difference to both two groups(P >0.05).The image CNR of arterial and venous phase in group A were higher than that of group B(40.89±8.89 and 40.27 ±9.90 in group A vs 35.28 ±8.43 and 34.89±8.66 in group B;P <0.05)respectively.There were no singnificant difference in the bone removal image scores of doub-le phase and in the vessel image scores of venous phase to both two groups respectively(P >0.05).The vessel image scores of arterial phase were higher in group A than that of group B(4.93±0.25 vs 3.87±0.97;P <0.05).Some internal carotid in the base of skull has not good luminal integrity in group B.The mean dose length product (DLP)in group A was lower than that of group B,with a 39 percent reduction[(226±5.69 )mGy/cm vs (368 ± 21.35 )mGy/cm,P < 0.05 ].Conclusion With the roughly similar image quality to dual-energy double phase subtraction angiography,the cerebral vessels can be assessed using dual-source CT subtraction angiography in Flash spiral scan mode and a lower radiation dose.

Objective To establish the ischemic precondition ([PC) model of PC12 cell line in vitro, and to explore the effect of nitric oxide (NO) on the IPC cerebral protection. Method PC12 cells were cultured and used for producing the model of ischemie precondition by the way of oxygen-glucose deprivation. Twenty dishes of cells were randomly divided into four groups (5 dishes for each group): control group, ischemic precondition group (IPC),non-ischemic precondition group (NIPC) and L-NAME treatment group (L-NAME). In control group, the cells were in-cubated with low glucose (<1 g/L) and2% FBS medium in normal oxygen; in IPC group, the cells were administrated with oxygen-glucose deprivation (OGD) for 6 hours, and then subjected with reperfuaion before OGD 15 hours; in NIPC group, the cells were treated the same as control group for 6 hours, and then subjected with reperfusion before OGD 15 hours; in L-NAME group, the cells received L-NAME (1 mmol/L) and cocultured for 30 minutes before OGD 6 hours, and then received the same treatment as the IPC group. To test whether the model was established, metabolic rate of MIT, LDH release were measured and the apoptosis rate was detected by flow cytometry following oxygen-glucose deprivation 15 hours. The activity of nitric oxide synthases (NOS) was as-sessed by biochemical assay. One-way ANOVA and LSD multiple comparison test were used to analyze differences among different groups, and P<0.05 was considered different. Results Compared with NIPC group, the metabolic rate of MTT increased (94.9%±35.1%, P<0.05), while LDH release and the cell apoptotic rate decreased significantly in IPC group (279.1%±28.1%, P<0.03). Compared with control group(100.0%± 13.5%),the activities of NOS increased both in NIPC and IPC groups (390.0%±14.6%, P<0.01;126.3% ±10.6%, P<0.01). Moreover, the apoptosis rates in each group (control group, IPC group, NIPC group and L-NAME group) were 5.90, 8.73, 38.62 and 11.73%,respectively. Conclusions IPC reduces the death and apoptosis rate of PC12 cell after oxygen-glucose deprivation injury. NO might be involved, but it is not the only factor.

Facing current situation of integrative medicine (IM), authors put forward that clinical and diagnosis program of IM could be carried out from clinical path, pathogenesis, treatment theory and philosophy, and so on, but with different integration degrees. Meanwhile, formulation of concrete program should be disease-targetedly set up, and adjusted from person to person, from place to place, from time to time. As for settled IM program , authors could evaluate it from whether Chinese medicine and Western medicine have formed complementary, synergistic, excitatory actions, and toxicity attenuation; whether more problems could be solved in efficacy, safety, practicability, and economy than previous single mode.
Critical Pathways ; Integrative Medicine ; trends ; Medicine, Chinese Traditional ; trends

OBJECTIVETo observe analgesic and sedative effect of acupuncture combined with medicine (ACM) on patients undergiong cardiac surgery.

METHODSA total of 50 patients with cardiac surgery from January 2012 to October 2014 were randomly assigned to the conventional analgesia group (group A) and the ACM analgesia group (group B), 25 in each group. Patients in group A were subjected to analgesia and sedation by injecting dexmedetomidine, while patients in group B were subjected to analgesia and sedation by electro-acupuncture [EA, Shenting (GV24); Yintang (EX-HN3)] combined with injection of dexmedetomidine. Morphine hydrochloride injection was performed when analgesia and sedation effect was ineffective in the two groups. The indicators of patients at different time points in the two groups were observed, such as static and dynamic VAS scores, SAS scores, mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2). The injection dosage of dexmedetomidine and morphine hydrochloride, analgesia satisfaction rate, sedation satisfaction rate, the incidences of adverse reactions during treatment such as bradycardia and low blood pressure, mechanical ventilation time, ICU time, and hospitalization expense were observed and recorded in the two groups.

RESULTSThere was no statistical difference in static and dynamic VAS scores, SAS score, MAP, HR and SpO2 between the two groups at different time points (P > 0.05). The injection dosage of dexmedetomidine and morphine hydrochloride was significantly reduced in group B than in group A (P < 0.05). The analgesia satisfaction rate of patients in group B was much higher than that in group A (P < 0.05). The incidence of bradycardia also obviously decreased more in group B than in group A (P < 0.05). There was no statistical difference in patients' sedation satisfaction rate, incidences of low blood pressure, delirium, vomiting; mechanical ventilation time, ICU time, or hospitalization expense between the two groups (P > 0.05).

CONCLUSIONThe analgesia method of ACM could reduce the dosage of traditional analgesic drugs and the occurrence of partial adverse reactions.

Acupuncture Analgesia ; Analgesia ; methods ; Analgesics ; therapeutic use ; Cardiac Surgical Procedures ; Dexmedetomidine ; therapeutic use ; Electroacupuncture ; Heart Rate ; Humans ; Hypnotics and Sedatives ; therapeutic use ; Morphine ; therapeutic use ; Pain ; prevention & control ; Pain Management ; methods ; Respiration, Artificial

In order to study the regularity of shedding virus from infected SPF chickens and the formation of aerosol of H9N2 subtype AIV, SPF chickens were bred in a positive and negative pressure isolator. Aerosol samples were collected by AGI-30 (All Glass Impinger-30) extractor, and simultaneously trachea and cloaca samples were collected by tracheal swabs and cloacal swabs in different periods after challenged with vi- ruses. The above-mentioned samples were detected by HI, Dot-ELISA and RT-PCR methods. The results in- dicated that aerosols were isolated from the 4 days to the 43 days after inoculation. It was proved that H9N2 subtype AIV could copy themselves in respiratory passage and cloaca, and then could formation of aerosols. AIV H9N2 subtype could be isolated from cloacal and tracheal swabs 3 days after inoculation and lasted for 45 days, viruses were detected from all infected SPF chickens on 7 days.