Objective To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017. Methods Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five?stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top?down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression. Results In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (P<0.001). Conclusion The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.

Objective To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017. Methods Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five?stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top?down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression. Results In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (P<0.001). Conclusion The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.

OBJECTIVETo provide genetic diagnosis and counseling for a 2-year-old girl with typical Rett syndrome through analyzing the methyl-CpG binding protein 2 (MECP2) gene.

METHODSPotential mutation of the MECP2 gene was screened by DNA sequencing and multiplex ligation-dependent probe amplification (MLPA) analysis of members of the family as well as normal controls. Lymphocyte culture for karyotype analysis was carried out for the patient to exclude chromosomal abnormalities.

RESULTSThe karyotype of the girl was normal. No variation of the MECP2 gene was detected in the patient by direct sequencing. A heterozygosis variation, c.1072G>A in exon 4 of the MECP2 gene was detected in a normal female control, which was not found in other controls. The son and daughter of the female control were respectively heterozygous and homozygous carriers of the same mutation. By MLPA analysis, a heterozygosis deletion of exon 3 and part of exon 4 was detected in the patient. cDNA amplification and sequencing confirmed the presence of a 1176 bp deletion (c.27-1202del1176). The same deletion was not detected in the parents.

CONCLUSIONA large deletion in MECP2 gene was detected with MLPA in a patient featuring typical Rett syndrome. The same deletion was missed by sequencing analysis. With cDNA sequencing, the breakage point of the mutation can be mapped precisely.

Base Sequence ; Child, Preschool ; Exons ; Female ; Genetic Testing ; Genotype ; Humans ; Karyotyping ; Methyl-CpG-Binding Protein 2 ; genetics ; Mutation ; Rett Syndrome ; genetics

OBJECTIVETo study the effects of tetramethylpyrazine (TMP) on cardiac function and mortality rate in septic rats.

METHODSFifty male Sprague-Dawley rats were randomized into a sham-operation group (sham group, n=10), normal saline group (NS group, n=20), and TMP group (n=20). The rats in the NS and TMP groups underwent cecal ligation and puncture (CLP) to induce sepsis. Rats in the NS group were injected with NS (10 mL/kg) immediately after CLP and 6 h after CLP. Rats in the TMP group were injected with TMP (10 mg/kg) at the same time points. Twenty-four hours after modeling, the mortality rates were observed in each group. Cardiac function and serum concentration of tumor necrosis factor α (TNF-α) were also tested. The correlation between TNF-α and the ejection fraction (EF) was observed. Left ventricle specimens were reserved for histomorphologic study.

RESULTSCompared with the sham group, the NS and TMP groups had decreased EF values and increased mortality rates and serum TNF-α levels (P <0.05). The TMP group had a comparatively lower mortality rate and TNF-α level and a higher EF value compared with the NS group (P <0.05). Histomorphology indicated that myocardial inflammation in the TMP group was mild compared with that in the NS group. There was a negative correlation between TNF-α level and EF value (r=-0.583,P=0.000).

CONCLUSIONTMP could reduce the mortality rate of septic rats and had certain protective effects on cardiac function.

Animals ; Heart Function Tests ; drug effects ; Male ; Myocardium ; pathology ; ultrastructure ; Pyrazines ; pharmacology ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Sepsis ; blood ; diagnostic imaging ; drug therapy ; physiopathology ; Stroke Volume ; drug effects ; Survival Analysis ; Tumor Necrosis Factor-alpha ; blood ; Ultrasonography

To investigate the intracellular mechanism of activity-dependent synapses formation and redistribution, we studied the electrophysiological and morphological characteristics of neurons of the developing visual cortex, and observed the level of synchronism of age and changes in the properties. Whole cell patch-clamp recordings and intracellular biocytin staining were used to record postsynaptic currents (PSCs) from neurons in the visual cortex of Sprague-Dawley rats (postnatal d 4-28). The histological processing was made. There were three types of PSCs in 156 cells: silent response, monosynaptic response and polysynaptic response, during the first developmental month. Before eyes opened the number of the neurons with the silent response (57.3%) was significantly higher than that after the eyes opened (11.9%) (P<0.001). However, the incidence of polysynaptic PSCs increased from 12.4% before eyes opened to 28.9% after eyes opened (P<0.01). During postnatal week 1, all cells were classified as immature. The immature cells had very high input resistances (R(N)>1.0 G Omega), low amplitude (-0.87 mA) and short decay time (-0.98 ms). During postnatal week 4, all cells were mature with lower input resistance (R(N)<310 M Omega), larger amplitude (-66 mA), and longer decay time (-225 ms). From postnatal weeks 1 to 3, the cells had electrophysiological properties that were intermediate between the immature and mature types of cells. With biocytin intracellular staining, five types of neurons were obtained: pyramidal cells, satellite cells, basket cells, neuroglial cells and immature cells. On the basis of their electrophysiological and morphological characteristics, pyramidal cells were classified into three categories: immature, intermediate, and mature cell types. During postnatal week 1, cells were immature with very high input resistance. Morphologically immature cells had short simple dendritic arborizations which incompletely penetrated the layer where the cell body lies. From postnatal weeks 2 to 4, the cells were mature with low input resistance. They were morphologically more complex with dendritic arborizations which completely penetrated the whole layers of the visual cortex. From postnatal weeks 1 to 2, a third, intermediate cell type had electrophysiological properties that were intermediate between the immature and mature cell types. Three distinctive types of pyramidal cells in visual cortex only co-exist during postnatal weeks 1 to 2. Data show that activity-dependent synapes are formed and integrated into local neuronal networks with visual stimulation. In the critical period of visual development, the level of synchronism of age and changes in electrophysiological and morphological properties in the visual cortex is higher than that in the subcortex.
Animals ; Animals, Newborn ; Excitatory Postsynaptic Potentials ; physiology ; Neurons ; cytology ; physiology ; Pyramidal Cells ; cytology ; physiology ; Rats ; Rats, Sprague-Dawley ; Synapses ; metabolism ; physiology ; Visual Cortex ; cytology ; growth & development ; physiology

OBJECTIVETo investigate the causes of acute respiratory distress (ARDS) after thoracotomy and to find out the measures to prevent ARDS.

METHODSThe characteristics of incidence, pathogenicity and treatment of ARDS after thoracotomy in 31 patients were analysed.

RESULTSThe patients who had chronic obstructive pulmonary disease, long history of smoking, hypertension were prone to ARDS. Injury to lung in operation, shock and pulmonary infection probably caused ARDS. Clearing away respiratory tract secretion, preserving of a clear airway, controlling pulmonary infection, alleviating pneumonedema by diuresis, early executing tracheotomy or mechanic assistant ventilation by tracheointubation were keys to rescuing patients successfully.

CONCLUSIONSIt is suggested that multi factors were related to ARDS after thoracotomy. Shock, injury to lung in operation, pulmonary infection, are important factors that lead to post-operative ARDS after thoracotomy. Early treatment can reduce mortality of ARDS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Respiratory Distress Syndrome, Adult ; etiology ; prevention & control ; therapy ; Thoracotomy ; adverse effects

OBJECTIVEA randomized trial of breast self-examination (BSE) Program was carried out to evaluate whether the intensive BSE could reduce the number of deaths among women from breast cancer.

METHODSThis study was a randomized controlled trial (RCT). A total of 266 064 women (age of 30 to 64 years) associated with 519 textile factories in Shanghai had been randomly assigned to a BSE group (132 979 women) or a control group (133 085 women) since 1989. Initial instruction in BSE group would include demonstration of proper palpation techniques and was followed by 2 reinforcement sessions during the subsequent 4 years including video shows, BSE instruction sessions and BSE practice under medical supervision. These activities were continued for 5 years. Attendance at all events was recorded. The cohort was followed through July 2000 for development of breast diseases, and the breast cancer cases were followed through 2001 for vital status. Data analysis methods used would include Kaplan-Meier plots, log-rank test and Cox modeling.

RESULTSAmong women under instruction, 864 breast cancers detected and 133 breast cancer deaths occurred while 896 breast cancers were detected and 130 deaths recorded in the control group. The tumor size (P = 0.07), TNM stage (P = 0.39) and cumulative breast cancer mortality rate (P = 0.72) were not significantly different between the 2 groups. However, more and smaller fibroadenomas were detected in the instruction group than in the control group (P< 0.01).

CONCLUSIONIntensive instruction in BSE did not seem to have reduced the mortality rate of breast cancer, but more and smaller benign breast lumps could be detected.

Adult ; Breast Diseases ; diagnosis ; Breast Neoplasms ; diagnosis ; mortality ; Breast Self-Examination ; China ; Female ; Humans ; Middle Aged ; Patient Education as Topic

OBJECTIVETo investigate the oral health knowledge and habits of freshmen of Sichuan University and promote the prophylactic therapy of dental diseases in the university.

METHODSThe table and the standard on oral health survey authorized by WHO were employed in this study.

RESULTSOnly 13.1% of all the investigated freshmen had periodic oral health examination. 74.4% brush teeth twice per day, only 7.7% brush teeth over 3 minutes, 16.6% insist in fluoridated toothpaste, and only 6% had applied dental floss. 51.9% do not often take snack food and 94.7% are non-smokers; (4) Tests of prophylactic therapy of dental caries and periodontal diseases and oral health knowledge have poor results.

CONCLUSIONThe freshmen have limited knowledge of oral health and lack serious attitude toward oral cleaning behaviors.

Health Knowledge, Attitudes, Practice ; Humans ; Oral Health ; statistics & numerical data ; Oral Hygiene ; statistics & numerical data ; Students ; Universities

OBJECTIVETo investigate the effect of simulated microgravity on erythroid differentiation of K562 cells and explore the possible mechanism.

METHODSThe fourth generation rotating cell culture system was used to generate the simulated microgravity environment. Benzidine staining was used to evaluate the cell inhibition rate, and real-time quantitative PCR (qRT-PCR) was used to detect GATA-1, GATA-2, Ets-1, F-actin, β-Tubulin and vimentin mRNA expressions. The changes of cytoskeleton were observed by fluorescence microscopy, and Western blotting was employed to assay F-actin, β-tubulin and vimentin protein expression levels.

RESULTSBenzidine staining showed that simulated microgravity inhibited erythroid differentiation of K562 cells. K562 cells treated with Hemin presented with increased mRNA expression of GATA-1 and reduced GATA-2 and Ets-1 mRNA expressions. Simulated microgravity treatment of the cells resulted in down-regulated GATA-1, F-actin, β-tubulin and vimentin mRNA expressions and up-regulated mRNA expressions of GATA-2 and Ets-1, and reduced F-actin, β-tubulin and vimentin protein expressions. Exposure to simulated microgravity caused decreased fluorescence intensities of cytoskeletal filament F-actin, β-tubulin and vimentin in the cells.

CONCLUSIONSimulated microgravity inhibits erythroid differentiation of K562 cells possibly by causing cytoskeleton damages to result in down-regulation of GATA-1 and up-regulation of GATA-2 and Ets-1 expressions.

Actins ; metabolism ; Cell Differentiation ; Down-Regulation ; GATA1 Transcription Factor ; metabolism ; GATA2 Transcription Factor ; metabolism ; Hemin ; pharmacology ; Humans ; K562 Cells ; Proto-Oncogene Protein c-ets-1 ; metabolism ; Tubulin ; metabolism ; Up-Regulation ; Vimentin ; metabolism ; Weightlessness Simulation

OBJECTIVETo evaluate the feasibility and the clinical practicality of the design about the hollowed titanium stick supporting the femoral head and preventing it from collapsing.

METHODSFrom Jan.2003 to Jun.2007, 36 patients (46 hips) diagnosed as cystis degeneration of the femoral head were treated by surgical operation, including 20 males and 16 females with an average age of 40 years ranging from 18 to 56 years old, and the course of the disease was from 10 to 24 months (16 months on average). According to ARCO staging,there were 24 patients (34 hips) in NFH II, of which 11 hips were II a stage, 13 hips were II b stage and 10 hips were II c stage; there were 6 patients diagnosed as osteofibrous,4 patients as simple bone cyst and 2 patients as chondromyxoid fibroma. Under X-ray the percutaneous narrow core decompression and focus infection elimination were performed and supported the sclerotin under the cartilage with titanium stick. The patients were followed-up at the first, third, sixth, twelfth, twenty-fourth and thirty-sixth month after the operation. The clinical evaluation was done by X-ray and the indexes included stable, unstable and abortive. The data was analyzed by Fisher exact probility and the suviaval rate was analyzed by Kaplan-Meier suviaval curve using statistical soft ware SPSS13.5.

RESULTSThere were no unstable or failure cases on each period from the 1st month to the 12th month after the operation, indicating that the supporting effect of the titanium stick was exact during 12 months after the operation. There were unstable and failure cases from the 12th month to the 24th month after the operation, which were mainly in stage NFH II c but the comparision of the stable rate in this period and 12 months after the operation had no obvious statistical differences (P>0.05) indicating that the supporting effect of the titanium stick was feasible during the stage. One of the unstable cases deteriorated and failed but there were no new unstable cases, both the stable rate and the unstable rate had no change and the failure rate rose on the 36th month after the operation. The compar- ision of the stable rate on each period after the operation had no obvious difference (P=0.197>0.05), which indicated that the supporting effect of the titanium stick was persistent. By the difference of the etiology the three-year survival rate of the relevant NFH II c pathological changes was the lowest-70% and the survival rate of the pathological changes induced by other etiological factors was 90.2%.

CONCLUSIONThe design about the hollowed titanium stick supporting the collapsed femoral head is feasible. Using the hollowed titanium stick to support the femoral head and prevent it from collapsing is pragmatic in the clinical and the effect is positive, however, when it comes to the NFH II c pathological changes, the choice should be made discreetly.

Adolescent ; Adult ; Feasibility Studies ; Female ; Femur Head ; diagnostic imaging ; surgery ; Follow-Up Studies ; Humans ; Internal Fixators ; adverse effects ; Male ; Middle Aged ; Prosthesis Design ; methods ; Titanium ; Tomography, X-Ray Computed ; Young Adult