Objective:To explore the curative care expenditure of the elderly(above 65 years old) in Jilin based on analyzing the economic burden of the elderly.Methods:Based on the System of Health Accounts 2011(SHA2011).it estimated the total curative care expenditure and constitute of the elderly in Jilin.Results:In 2014,the curative care expenditure of the elderly in Jilin reached to 12.85 billion yuan,which accounted for 26.26％ of curative care expenditure of the total population in Jilin.The per capita curative care expenditure of the elderly was 3.01 times of the per capita curative care expenditure of the 0-14 year-old group,2.87 times of the per capita curative care expenditure of the 15-64 year-old group and 2.39 times of the overall per capita curative care expenditure of residents in Jilin.From the perspective of service composition,the elderly treatment costs occurred more in the hospital with the increase in age.From the perspective of disease costs,the elderly treatment costs mainly occurred in the circulatory system diseases,respiratory diseases,cancer and other chronic diseases.The household out-of-pocket (OOP) accounted for 41.83％ in curative care financing for the elderly.Conclusion:The constitute of the curative expense of the elderly in Jilin province had significant characteristics,showed as heavy OOP burden.It needed to provide policy support.

Objective To study the correlation between the contrast enhancement features on spiral computed tomography (SCT) and different clinicopathological characteristics in hepatocellular carcinoma (HCC).Methods Fifty cases (54 lesions) of HCC proved pathologically and examined with enhancement dual-phase SCT scanning (arterial phase and portal vein phase) were included in this study. The SCT features and the clinical details about resection and pathological differentiation were recorded. All the features of SCT were compared with some clinical and histopathological characteristics of HCC.Results The features of SCT were correlated with pathological characteristics of HCC. The pseudocapsula patterns were related with Edmondson's grade, and the enhancement patterns were associated with the diameter of tumor and intratumoral necrosis. There was a significant correlation between the high infiltration and severity (intrahepatic daughter foci, tumor-emboli in portal veins, lymphatic metastasis) on the SCT images and the diameter of tumor. The same correlation was found between the diameter of tumor on the SCT images and AFP value, and also between hepatic cirrhosis on the SCT images and HBsAg, the diameter of tumor.Conclusion This research confirms that SCT features are correlated with some clinicopathological characteristics of HCC.

BACKGROUND: More recently,repair of skull defect with computer-designed prosthesis contributes to the revolutionary development of skull reconstruction technique. OBJECTIVE: To individually molded titanium mesh by computer-aided design (CAD) technique,and to observe the clinical application value of the titanium mesh in the repair of large-area skull defects in the fronto- temporo-parietal lobes. DESIGN,TIME AND SETTING: A retrospective case analysis was performed at the Department of Neurosurgery,Liuzhou People's Hospital between January 2006 and August 2007.PARTICIPANTS: A total of 16 patients comprising 12 males and 4 females,aged 16-52 years,suffered from skull defects in the fronto-temporo-parietai lobes following standard large trauma craniotomy and were recruited into this stud Two of these patients were complicated by hydrocephalus and received ventriculoperitoneal shunt. Skull defect area ranged between 9. 2 cm ×11.2 cm and 12.2 cm×14.6 cm. Skull defect neoplasty was performed in all patients 3-8months following standard large trauma craniotomy. METHODS: Titanium mesh patches were individually modeled by CAD,computer-aided manufacturing (CAM) and rapid shaping techniques and implanted into skull defect region. In addition,defect edge was fastened with titanium nails. MAIN OUTCOME MEASURES: Moulding effects and complications following skull defect neoplasty. RESULTS: A small amount of subcutaneous effusion was found in one patient and disappeared after liquid extraction and pressure dressing. Titanium mesh was firmly fixed with no loosening. Patients exhibited left-right symmetry,appropriate lateral curvature,no irregular umbilication or chewing dysfunction. All patients were followed for 3-18 months postoperatively and were satisfied with good resuRs,Le.,no complications,infection,material exposure,loosening,or collapse. CONCLUSION: CAD technique used for repair of skull defects is convenient,effective,and safe. This method can. reduce postoperative complications and improve repair effects.

Objective:To analyze the characteristics of elderly patients with moyamoya disease and clinical outcomes after combined revascularization, and to evaluate the safety and efficacy of this method in elderly patients.Methods:Moyamoya disease patients aged 60 years or older who had undergone combined revascularization at the Neurosurgery Center of Aeronautical General Hospital from January 2016 to September 2021 were selected as study subjects.Then patients' clinical data and postoperative complications within two weeks of surgery were collected and a followed-up was conducted.The results were compared with those of previous reports.Results:A total of 46 combined revascularization procedures were carried out in 30 patients.The ages at surgery ranged between 60-75 years, with a mean age of(66.1±4.4)years.The rate of complications within two weeks after surgery was 37%, and the most common complication was speech dysfunction, followed by epilepsy and hyperperfusion.No serious complications such as cerebral hemorrhage and death occurred.The follow-up varied between 3-67 months, with an average follow-up time of(26.8±18.4)months.The MRS score was <3 at 3 months after surgery, and there was no death or severe disability.Conclusions:Perioperative complications in elderly patients with moyamoya disease have a higher incidence rate than in other populations, but patients can usually recover after close perioperative management for 2 weeks.The follow-up has demonstrated that outcomes at 3 months and in longer terms after surgery are satisfactory and clinical symptoms will improve significantly.

Objective To understand the relationship of anxiety and depression with AIDS knowledge,cognition of risk and sex behavior among young men who have sex with men(YMSM).Methods The study was conducted by the snowballs sampling method for the recruitment and serological examination of YMSM aged 15-24 in Mianyang city,Sichuan province.The anxiety and depressive symptoms were assessed by the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS).Chi-square test was used to implement single-factor analysis and non-conditional logistic regression for multiple-factor analysis.Results Totally 356 cases completed the SAS and 355 cases completed the SDS.And the total scores of SAS and SDS were (42.96± 10.81) and (45.63± 12.40).The detection rates of anxiety and depressive symptoms were 23.60％ and 33.24％ respectively.There was no statistical difference in the incidence of HIV infection with or without anxiety and depression (x2=2.235,1.718,both P＞0.05),and there was a statistical difference in the incidence of syphilis infection (x2 =6.840,P＜0.05).Multi-factor analysis results showed that HIV infection risk awareness(β=1.101,P=0.015),number of anal sex in nearly 1 week (β=1.111,P=0.005),and the diagnosis of STD in nearly 1 year(β=1.996,P=0.010) were independent factors influencing anxiety symptoms,meanwhile occasional sex in nearly six months (β=0.692,P=0.037),and the number of anal sex in nearly one week (β=0.969,P=0.012) were independent factors in depressive symptoms (P＜0.05).Conclusion The detection rate of anxiety and depressive symptoms among YMSM is high.Anxiety and depressive symptoms are related to AIDS related factors,which has certain characteristics to the YMSM sex behavior and is of great health risk.AIDS prevention should combine behavior with psychological intervention.