Objective: To understand the gambling relations between the stakeholders of catastrophic medical insurance policy under New Rural Cooperative Medical System ( NCMS) , and provide theoretical references for the smooth operation of catastrophic medical insurance policy of NCMS. Methods:Analyzing the game relationships among the four sides:the government, business insurance agencies, designated medical institutions and participating farmers suffering from catastrophic diseases through game theory. Results: The government and business insurance agency, and the government and designated medical institution belong to cooperative games. The farmers participated in catastrophic medical insurance tend to choose cooperative strategy. Non-cooperative games exist in business insurance agency, designated medical institution and participating farmers. Conclusion: Strategic relationship of close cooperation should be established between the business insurance agencies and designated medical institutions. The government should strengthen the regulatory constraints between the business insurance agencies and designated medical institutionsi, at the same time, it needs to establish the incentive mechanism soon.

Objective To understand the feeling of mothers of children with osteogenesis imperfecta during the accompany of children's diagnosis and treatment.Methods A total of 20 mothers of children with osteogenesis imperfecta participated the semi-structured interview.The data were analyzed by Colaizzi's method of phenomenology.Results Three themes were acquired including heavy psychological burden,facing multiple pressure and mother's support through analysis,reorganization and extraction of the subjects.Conclusions Mothers of children with osteogenesis imperfecta needed humanistic concern and emotional support.Nursers should adopted personalized care measures to improve their quality of life.

AIM: To optimize the extraction of Weining-Dispersible Tablet(Radix et Rhizoma notoginseng,Radix et Rhizoma ginseng) with the help of central composite design-response surface methodology. METHODS: The main influencing factors of extraction effect included the quantity of ethanol,the concentration of ethanol and extraction time and the extraction conditions were evaluated by the extract yield and the contents of total notoginseng saponins.The optimal extraction of Weining-Dispersible Tablet was selected by central composite design-response surface methodology. RESULTS: The optimal conditions consisted of extraction two times,2 h each time with ten fold of 70% ethanol. CONCLUSION: It is simple,convenient and high predictive to optimize the extraction craft of Weining-Dispersible Tablet by central composite design-response surface methodology.

AIM: To study the effect of IL-12 on T lymphocytes apoptosis, the expression of Fas/FasL and TNFR/TNF?. METHODS: Terminal dUTP nick end labeling(TUNEL) and Annexin V assay were used. Anti-TNFR were labeled with FITC, anti-CD95 was labeled with PE and Anti-FasL with biotin. Three kinds of T cells (HTB176,TIB152 and human normal T cells) were analysed through flow cytometry. RESULTS: At 1st hour after being treated with IL-12, the expression of FasL protein and FasL mRNA in HTB176 and TIB152 began to increase and reached peak value in 24 hours. In the normal T cells, FasL just began to increase in 1 hour and maintained stability in 6, 12 and 24 hours through the later experiment period. All three kinds of T cells displayed no change in the expression of CD95 and TNFR/TNF? under the stimulation of IL-12. CONCLUSION: Expression of such apoptosis regulating factors were different in the apoptosis of T cells induced by IL-12.

Purpose To explore the practical significance of TERC gene amplification by fluorescence in situ hybridization ( FISH) on the differential diagnosis of cervical intraepithelial neoplasias 1 and 2 by tissue microarray. Methods A total of 42 cases of cervical tissue samples were selected, including 20 cases of normal cervix, 22 cases of cervical intraepithelial neoplasia (CIN) 1/2 (8 cases of CIN1 and 14 CIN2). Homemade tissue microarray was prepared. TERC gene amplification was detected with FISH method. Results TERC gene showed no amplification in the normal cervical squamous epithelium. TERC gene amplification was detected in 22. 7%(5/22)CIN1 and 77. 3%(17/22) in CIN2. 1/8 cases of TERC gene amplification in CIN1, 4/14 cases of TERC gene amplification in CIN2. There were significant differences in TERC gene amplification between those groups (P<0. 05). Conclusion The method is feasible and reliable in the detection of TERC gene amplification in CIN1/2 on paraffin sections. It has practical values in differential diagnosis between CIN1 and CIN2.

ObjectiveTo provide anatomical basis of neural transplantation to repair deep branch of ulnar nerve defect with the ring finger radial digital branch.MethodsThirty-two sides of 16 cases fresh forearms were dissected and observed.Microdissect and measure the deep branch of ulnar nerve,quadrate pronator of median nerve and it's ring finger radial digital branch under 10-times operating microscope. ResultsThe diameter of quadrate pronator of median nerve was (1.13 ± 0.02)mm,ring finger radial digital branch of median nerve was (1.17 ± 0.05)mm,mid-palmar section of deep branch of ulnar nerve was(1.75± 0.07)mm.Dissect ring finger radial digital branch of median nerve to muscular branch of quadrate pronator under operating microscope,retaining it's blood supply.The length between the deep branch of ulnar nerve and ring finger radial digital branch was( 104.59 ± 20.25)mm.Conclusion①Solving the problem of nervegrafting without blood supply before,benefit to the survival of the grafting segment and the regeneration of the neuro fiber,and function restoring.②This kind of grafting is the bridging of muscular branch to muscular branch,abide by the principle of neurophysiology.③Neural transplantation to repair deep branch of ulnar nerve defect with the ring finger radial digital branch is an effective method.

In this research project, rats were made into animal models of acute focal cerebral ischemia and reperfusion (IR) by occlusion of their middle cerebral artery (MCAO). We observed the effect of endogenous endothelial progenitor cells (EPCs) and serum cytokines on cerebral ischemia rats treated by electro-acupuncture(EA). The results showed: MCAO model had high stability after EA treatment which was delivered via the acupuncture needles inserted into "quchi" and "zusanli" points, the nervous functions of cerebral IR rats recovered faster than those of rats not treated; EPCs in rats' blood increased after acute focal cerebral ischemia and reperfusion; and the growth rate was obvious in IR group. This phenomenon might be related to the inflammation elicited by injury of ischemia and self-repair. Besides, EA treatment could decrease induced nitric oxide synthase (iNOS) activity, alleviate injury after cerebral ischemia, and regulate the quantity of EPCs in blood. The quantity of EPCs in blood increased in IR-24hr. In IR-48 hr, the rise of EPCs quantity was significant (P < 0.01). The level of vascular endothelium growth factor (VEGF) in serum of rats after cerebral ischemia was escalated, which indicated to a certain extent that cerebral ischemia could stimulate stress reaction. EA treatment could raise VEGF level, which suggested that high expression of VEGF could accelerate mobilization, chemotaxis and homing of EPCs. At the same time, the levels of matrix metalloproteinase-9 (MMP-9) and basic fibroblast growth factor (bFGF) also changed. In conclusion, EA treatment could promote neovascularization after cerebral ischemia by mobilizing EPCs, decreasing iNOS activity and increasing VEGF level. This may be one of the ways by which EA could treat cerebral ischemia.
Animals ; Brain Ischemia ; blood ; complications ; pathology ; Cytokines ; blood ; Electroacupuncture ; Endothelial Cells ; cytology ; Infarction, Middle Cerebral Artery ; blood ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; blood ; pathology ; Stem Cells ; cytology

ObjectiveTo investigate the relationship of lymphotoxin β receptor (LTβR) and classical nuclear factor-κB (NF-κB) activation pathway in the pathogenesis and progress of cystitis and bladder cancer.MethodsThe LTβR and P65 mRNA expression were detected by Real-time quantitative PCR in 108 cases of fresh bladder tissue specimens (75 cases of bladder cancer,10 cases of inflammation and 23 normal bladder mucosa cases grouped by the tissue classification ),and protein expression were analyzed by immunohistochemistry assay in 118 cases of paraffin-embedded biopsy specimens (73 cases of bladder cancer,30 cases of cysitis and 15 normal bladder mucosa cases).The correlation analysis between the expressions of LTβR and P65 with clinical pathological data was then performed.Differences between LTβR and P65 mRNA and protein expression level were compared in different groups of bladder tissues using Kruskal-Wallis H test and the Chi-square test.Results( 1 )The mRNA expressions of LTβR and NF-κB/P65were higher in bladder cancer than those in normal group ( LTβR:29.4 ( 14.2 - 46.7 ) × 10 - 3/1.2 ( 0.3 -7.0) ×10-3,Z=-5.508; P65:9.7 (2.7 -21.1) ×10-3/1.0(0.8 ～1.8) ×10-3,Z=-5.030,P＜0.05 ).There were significantly differences between bladder cancer with different histological grades ( LTβR:18.2(2.1-31.3) × 10-3/ 28.4(16.6-36.2) × 10-3/47.9(34.3 -70.5) ×10-3,x2K-W=20.378;P65:4.9(1.3 - 12.0) × 10-3/7.4(3.0-21.9) × 10-3/17.0(10.0 ～28.3)× 10-3 ,x2K-W2 =15.219,P all ＜0.05) and lymph node metastasis (LTβR:27.2(9.7-40.1) ×10-3/39.4(26.7 -52.6) ×10-3,Z=-2.552; P65:7.4(2.3-15.6) ×10-3/13.4(6.7-23.3) ×10-3,Z=-2.026,P＜0.05).(2)The positive rates of LTβR and phosphorylated P65 ( p-P65 ) protein in cancer were higber than those of normal group (LTβR:69.8％/13.3％,x2 =16.600 ; p-P65:56.2％/6.7％,x2 =12.220,P ＜ 0.05 ).Upregulation of LTβR and p-P65 were associated with the histological grade (LTβR:56.3％/70.0％/90.4％,x2 =7.055; p-P65:40.6％ /60.0％/76.2％,x2 =6.679,P ＜0.05) and with lymph node metastasis (LTβR:58.3％/92.0％,x2 =8.849; p-P65:52.1％/64.0％,x2 =5.088,P ＜0.05).(3)There was a positive correlation between LTβR and P65 expression ( mRNA:r =0.654,P ＜ 0.05,protein:r =0.399,P ＜ 0.05 )in the bladder cancer and cystitis (r =0.521,P＜0.05).ConclusionsThe activation of LTβR and P65 was associated with progression and metastasis of bladder cancer.The activation of classical NF-κB pathway by LTβR may be achieved by P65.

A series of 4-(N-aryl)amino-6-alkoxyl pteridine derivatives was designed and synthesized via the bio-isostere principle using anti-cancer drugs with quinazoline cores as lead compounds.The proliferative inhibitory activities of the synthesized compounds against tumor cells A549,KG1a and HGC-27 were also performed by MTT assay.Using methyl 3-aminopyrazine-2-carboxylate as the starting material,12 target compounds(7a-7l)were synthesized through six-step reaction, and characterized by 1H NMR, 13C NMR and MS.It was showed that antitumor activity of pteridines with 2-chloro-5-nitro-anilino substituted in position 4 was more potent than that of others.The activity of compound 7b on A549 cells(IC50=11.55 μmol/L)was closely approximate to that of positive control gefitinib(IC50=5.95 μmol/L).IC50values of compound 7k on three cell lines were all close to those of gefitinib.A 2-chloro-5-nitro-anilino fragment was contained in preferred compounds which might be modified for further investigation.

Purpose: This study aims to elucidate the longitudinal alterations in frailty and health-related quality of life experienced by elderly patients undergoing surgical treatment for esophageal cancer. Additionally, it seeks to ascertain the impact of preoperative frailty on postoperative health-related quality of life over time. Methods: 131 patients were included in the prospective study. Patients' frailty and health-related quality-of-life were assessed utilizing the Tilburg and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at preoperative, 1 week, 1 month, and 3 months, postoperatively. Statistical analyses were performed using generalized estimating equations, repeated-measures analysis of variance, and linear mixed models (LMMs). Results: Out of 131 patients, 28.2% had frailty before surgery, and the prevalence of frailty consistently higher after surgery compared with baseline (67.9%, 51.9%, and 39.7%). There was no significant change in frailty scores in preoperative frail patients within 3 months following surgery (p = .496, p < .999, p < .999); whereas in preoperative non-frail patients, the frailty scores increased at 1 week (p < .001) and then decreased at 1 month (p = .014), followed by no change at 3 months. In addition, preoperative frail patients had significantly worse global quality-of-life (β = −4.24 (−8.31; −.18), p = .041), physical functioning (β = −9.87 (−14.59; −5.16), p < .001), role functioning (β = −10.04 (−15.76; −4.33), p = .001), and social functioning (β = −8.58 (−15.49; −1.68), p = .015), compared with non-frail patients. Conclusions A significant proportion of participants exhibited a high prevalence of preoperative frailty. These patients, who were preoperatively frail, exhibited a marked reduction in health-related quality-of-life, a more gradual recovery across various functional domains, and an increased symptom burden during the follow-up period. Therefore, it is crucial to meticulously identify and closely monitor patients with preoperative frailty for any changes in their postoperative physiology, role, and social functioning.