Objective: To analyse the composition of hospitalization childbirth costs and its influencing factors, which provides theory basis on reasonable control of rapid growth of hospitalization childbirth costs. Methods: With the method of stratified random sampling, 12 secondary and tertiary hospitals were chosen in Shanghai. According to the hospitalization number, the maternal disease cases delivering from Jan. 1, 2016 to Jun. 30, 2016 were randomly selected. The basic information and the cost of hospitalization were collected, and the database was established. Descriptive statistics, z test, non-parametric test and multiple linear stepwise regression analysis were performed by SPSS 20.0. Results: The cost of hospital delivery per capita in Shanghai from Jan. to Jun. 2016 was 7 826.39 yuan, of which the cost of bed, inspection, operation and western medicine accounted for the highest proportion of the expenses (17%, 16%, 15% and 15%, respectively). Maternal hospitalization cost univariate analysis showed that the effect of age, occupation, payment, pregnancy complications, modes of delivery, length of stay, prenatal and postnatal pathological condition on hospitalization cost were statistically significant. A multifactorial study on the cost of hospitalization showed that the delivery mode, length of stay, prenatal and postnatal pathological pathological condition, age and pregnancy complications were the main influencing factors. Conclusion: The hospitalization cost of cesarean section is significantly higher than that of vaginal delivery, the hospital cost structure of these two modes of delivery is different, and the reduction of cesarean section rate is of great significance. It is necessary to optimize the hospital cost structure via controlling the cost of western medicine, operation, and inspection.

Objectives: To analyze the strategies of the diagnosis and treatment in patients with the pulmonary infection after renal transplantation. Methods: A retrospective analysis was made on 28 cases of pulmonary infections among 285 patients undergoing renal transplantation. Results: The morbidity of pulmonary infection was 9.82%(28/285). The majority pathogens of pulmonary infection in this study were pseudomonas, staphylococcus epidermidis, canadida and cytomegalovirus. Chest X ray was important in the diagnosis, but there was no specificity to determine the pathogens. The mortality in 28 pulmonary infection patients was 32.1%(9/28). Most of the patients suffered from pulmonary infection within 4 months after the operation, and the postoperative period from 2 months to 4 months was a high risk time window for death caused by pulmonary infections. Conclusions: The morbidity and mortality of pulmonary infections, especially severe pneumonia, in patients with renal transplantation, are higher than healthy people. Treatment following clinical epidemiology and strategy of microbiology play a very important role to reduce the mortality in those patients.

BACKGROUNDThe lung functional status could be displayed on lung perfusion images. With the images, the radiotherapy plans of lung cancer could be guided to more optimized. This study aimed to assess quantitatively the impact of incorporating functional lung imaging into 3-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiation therapy (IMRT) planning for non-small cell lung cancer (NSCLC).

METHODSTen patients with NSCLC who had undergone radiotherapy were included in this study. Before radiotherapy, each patient underwent CT simulation and lung perfusion imaging with single photon emission computed tomography (SPECT). The SPECT images were registered with simulation planning CT and used to contour functional lung (lung-F) and non-functional lung (lung-NF). Two 3DCRT plans and two IMRT plans were designed and compared in each patient: two anatomic plans using simulation CT alone and two functional plans using SPECT-CT in addition to the simulation CT. Dosimetric parameters of the four types of plans were compared in terms of tumor coverage and avoidance of normal tissues. Total radiation dose was set at 66 Gy (2 Gy x 33 fractions).

RESULTSIn incorporating perfusion information in 3DCRT and IMRT planning, the reductions on average in the mean doses to the functional lung in the functional plan were 168 cGy and 89 cGy, respectively, compared with those in the anatomic plans. The median reductions in the percentage of volume irradiated with > 5 Gy, > 10 Gy, > 20 Gy, > 30 Gy and > 40 Gy for functional lung in the functional plans were 6.50%, 10.21%, 14.02%, 22.30% and 23.46% in 3DCRT planning, respectively, and 3.05%, 15.52%, 14.16%, 4.87%, and 3.33% in IMRT planning, respectively. No greater degree of sparing of the functional lung was achieved in functional IMRT than in 3DCRT.

CONCLUSIONFunction-guided 3DCRT and IMRT plannings both appear to be effective in preserving functional lung in NSCLC patients.

Carcinoma, Non-Small-Cell Lung ; diagnostic imaging ; pathology ; radiotherapy ; Humans ; Radiography ; Radiotherapy, Conformal ; methods ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, Emission-Computed, Single-Photon ; methods

OBJECTIVETo study the relationship between invasive growth and the angiogenesis factors and their receptors in keloid.

METHODSBiopsies from 17 keloid (Ke) were divided into atrophy group (Ke-A, n = 9), proliferating group (Ke-P, n = 13), infiltrating group (Ke-I, n = 9), normal skin around Ke (Ke-N, n = 10) and normal skin (NS, n = 10). The histology, immunohistochemistry and computerized imaging analysis were used for the study. The levels of basic fibroblast growth factor (bFGF) and its receptor-Flg, vascular endothelial growth factor (VEGF) and VEGF/KDR complex (11B5), and platelet derived growth factor (PDGF-A) and its receptor-PDGFR-alpha, and alpha-smooth muscle actin (alpha-SMA) were determined in specimens with immuneohistochemical staining.

RESULTSIn all 5 groups, bFGF, Flg, VEGF, 11B5, PDGF-A, and PDGFR-alpha were all expressed in fibroblasts (Fb), monocyte-phagocytes, vascular endothelial cells, adventitial cells, epidermal (cells and epithelial cells in appendage. The intensities of staining ranked as follows: Ke-I > Ke-N approximately equal to Ke-P > Ke-A approximately equal to NS, Flg > hFGF approximately equal to PDGFR-alpha > PDGF-A approximately equal to 11B5 > VEGF (P < 0.05 to approximately 0.01). 11B5 and VEGF were expressed (intensively in alpha-SMA positive myofibroblasts only in Ke-I group. The histological observation showed hyperplasia of endothelial cells and obliteration of microvessels.

CONCLUSIONThe invasive growth of keloid may be related to the overexpression of angiogenesis factors and their receptors. The abnormal expression of 11B5 in myofibroblasts may be one of the important factors associated with tumor-like growth feature in the invasive parts sites of keloid. The results suggest that inhibition of these biological activities would be of significance in clinical therapy.

Adolescent ; Adult ; Aged ; Angiogenesis Inducing Agents ; analysis ; Child ; Child, Preschool ; Female ; Fibroblast Growth Factors ; analysis ; Fibroblasts ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Infant ; Keloid ; metabolism ; pathology ; Male ; Middle Aged ; Platelet-Derived Growth Factor ; analysis ; Receptor Protein-Tyrosine Kinases ; analysis ; Receptor, Fibroblast Growth Factor, Type 1 ; Receptor, Platelet-Derived Growth Factor alpha ; analysis ; Receptors, Fibroblast Growth Factor ; analysis ; Receptors, Growth Factor ; analysis ; Skin ; chemistry ; pathology ; Vascular Endothelial Growth Factor A ; analysis

OBJECTIVETo evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of lesions in the sellar region.

METHODSThe MRI data of 142 patients with surgically and pathologically proved lesions in the sellar region were retrospectively analyzed. Based on the MRI findings, the lesions were divided into pituitary adenoma and sellar region diseases except pituitary adenoma. According to the pathologic features, the sellar region diseases except pituitary adenoma were further divided into cystic lesions, parenchymatous lesions, and cystic and parenchymatous lesions.

RESULTSOf these 142 patients, pituitary adenoma was found in 30 cases, cystic lesions of sella region diseases except pituitary adenoma in 24. Further classification resulted in 66 cases of parenchymatous lesions and 22 cases of cystic and parenchymatous lesions.

CONCLUSIONMRI-based classification of lesions in the sellar region is useful for the diagnosis and differential diagnosis.

Adolescent ; Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pituitary Diseases ; diagnosis ; Retrospective Studies ; Sella Turcica ; Young Adult

OBJECTIVESTo investigate the changes of liver function during the course of serious acute respiratory syndrome (SARS) and to explore its possible influence factors.

METHODSThere were 91 patients with common SARS, and 23 patients with severe SARS, and 61 common pneumonia patients served as the controls. The liver functions of all the patients were measured.

RESULTSThe rate of anomaly liver function in the common SARS patients group was 68.1%, which was higher than that in the common pneumonia patients group (24.6%), chi2=27.7, P<0.01. The changes mainly existed in the mild to moderate elevation of alanine aminotransferase and aspartate aminotransferase. The severe SARS patients were older and the changing rate of liver function was as high as 95.7%.

CONCLUSIONSThe damage possibility of liver function in SARS patients is higher than that in common pneumonia patients. The damage is light and related to SARS itself. The damage of liver function in the severe SARS patients may have close relationship with age.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Liver ; physiopathology ; Male ; Middle Aged ; Pneumonia ; physiopathology ; Severe Acute Respiratory Syndrome ; physiopathology

ObjectiveBy analyzing the epidemiological characteristics and trends of brucellosis in Hebei province,provide a scientific basis for the formulation of strategies for effective prevention and control of the disease.MethodsUsing the descriptive epidemiological method,data of the “China information system for disease control and prevention” from 2006 to 2010 were statistically analyzed.ResultsThere were 13 632 reported cases from 2006 to 2010 in Hebei province,no death,the annual incidence rates reported were 3.4068/10 million,3.4851/10 million,4.5701/10 million,4.6045/10 million,and 3.5582/10 million,respectively.Eleven counties throughout the province had reported cases.The cases were found intensively in Zhangjiakou,Chengde,Baoding,Handan and Shijiazhuang,which accounting for 90.02％ (12 271/13 632) of the total cases.The disease was found each month throughout the year,and showed a seasonal cycle with peak period in spring and summer.The disease was most commonly found in 25 - 65 age people,which accounting for 84.57％(11 529/13 632).The incidence in male was higher than that of female,and male to female ratio was about 3.56:1.00.Vocational high risk population was farmers,accounting for 91.15％ of the total cases(12 425/13 632).ConclusionsBrucellosis epidemic in Hebei province is relatively serious,and the epidemic range has expand each year,even highly active in some particular areas.To control the outbreak of brucellosis,departments cooperation between health and animal husbandry should be strengthened; management of source of infection should be strengthened; health education and behavior intervention should be carried out thoroughly and deeply for high-risk groups.

Aim To study the effects of Free Anthra-quinone from Rhubarb (FAR)on myocardial CTGF and collagen expression and interstitial fibrosis in dia-betic rats.Methods The male SD rats were randomly divided into normal group (CON),diabetic cardiomy-opathy group (DCM) and FAR treatment group (FAR).Streptozocin was intraperitoneally injected in-to the animals in the latter 2 groups to induce diabetic rat model.The model was expected to be stable for 2 weeks before the treatment.At the end of the 8th week in treatment,fasting plasma glucose and heart mass in-dex were measured.Masson staining was used to ob-serve the myocardial fibrosis.RT-PCR was used to de-tect the mRNA levels of CTGF,procollagen type Ⅰand collagen type Ⅲ.Immunohistochemical method was used to detect the content of CTGF.ELISA was used to detect the depositions of collagen type I and collagen type Ⅲ. Results Compared with CON group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of DCM group were signifi-cantly increased. However, compared with DCM group,fasting plasma glucose,heart mass index,the degree of myocardial fibrosis,and the expressions of CTGF,collagen type I and collagen type Ⅲ in left ven-tricular myocardial tissue of FAR-treated rats were sig-nificantly decreased.Conclusion FAR retards the process of myocardial fibrosis in diabetic rats by down-regulating the expression of CTGF,reducing the syn-thesis and depositions of collagen type I and collagen type Ⅲ.

The mechanics of a new shape memory alloy cervical hook for atlantoaxial instability was analyzed with finite element method on the basis of a three-dimensional model reconstructed from the images of CT scanning of an adult cadaveric upper cervical at 1-mm interval. The stress and displacement of every nodule and element in the course of deformation of the internal fixation were tested, and the results showed that the cervical hook was strong enough against tensile stress, which concentrates in the middle of the device. The pull was 237.58 N at the loading point. With such mechanical performance, this cervical hook can be reliable for correction of atlantoaxial instability.
Adult ; Alloys ; Atlanto-Axial Joint ; Cadaver ; Finite Element Analysis ; Humans ; Joint Instability ; diagnostic imaging ; surgery ; Male ; Memory ; Orthopedic Fixation Devices ; standards ; Orthopedic Procedures ; instrumentation ; methods ; Radiography ; Reproducibility of Results ; Tensile Strength

OBJECTIVETo detect the expression levels of telomere binding factor 2 (TRF2) on leukemia cell lines and primary leukemia cells.

METHODSThe expression of TRF2 mRNA was detected with quantitative real-time RT-PCR in leukemia cell lines and primary leukemia cells. The Western blot analysis was used for the detection of TRF2 protein expression.

RESULTTRF2 was overexpressed in T-cell leukemia cell lines but not in myelogenous leukemia cell lines. Significant higher expression levels of TRF2 were observed in primary leukemia cells from patients with M0 and M1 subtypes of acute myelogenous leukemia (AML) compared with normal control and other subtypes of AML.

CONCLUSIONIncreased TRF2 expression levels are found in T-cell leukemia cell lines and AML patients with poor prognosis, which suggests that TRF2 expression might be related to the prognosis of leukemia.

Adolescent ; Adult ; Female ; HL-60 Cells ; Humans ; Jurkat Cells ; K562 Cells ; Leukemia, Myeloid, Acute ; metabolism ; Leukemia, T-Cell ; metabolism ; pathology ; Male ; Middle Aged ; RNA, Messenger ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Telomeric Repeat Binding Protein 2 ; metabolism ; Young Adult