Objective To investigate the factors of hospitalization expense in patients with type 2 diabetes mellitus undergoing non-emergency surgery.Methods A retrospective study included diabetic (109 cases) and control (162 cases) groups.Hospitalization expense and other observation indices were compared between two groups and subgroups.The factors that contribute to hospitalization expense were analyzed with multifactor regression analysis model.Results The median hospitalization expense was 12 014.74 yuan in the diabetic group,1.24 times than that in the control group (P =0.001).Diabetic group has higher American Society of Anesthesiologists (ASA) classification,longer wound healing time,higher postoperative infection rate,and longer hospital stay (P ＜ 0.01).Multifactor analysis revealed that the significant factors that influence the hospitalization expense were ASA classification (β =0.442,P =0.000),postoperative fasting plasma glucose (β =0.204,P =0.020),and postoperative infection (β =0.204,P =0.019).No significant difference was found in postoperative infection rate and hospitalization expense between two groups,when patients had received minimally invasive surgeries (P ＞ 0.05).Conclusions Type 2 diabetes patients have higher hospitalization expense;ASA classification,postoperative fasting plasma glucose,and postoperative infection are the main influence factors.Giving priority to minimally invasive surgeries and enhancing perioperative glucose control can help to reduce hospitalization expense in patients with type 2 diabetes mellitus.

Objective:To assess the clinical efficacy of two different diameter Osstem MS one-stage implant restoration of small edentu-lous space in the mandibular anterior region.Methods:85 patients were treated by Osstem MS one-stage implant with the diameter of 2.5 mm(n =66)and 3.0 mm(n =66)respectively for the restoration of small edentulous space in mandibular anterior region.The mesi-al and distal marginal bone level and soft tissue were statistically analyzed after 1 2 and 24 months of functional load.The implant survival rate was evaluated according to Wheeler's survival criteria.Results:The survival rate of the implants was 1 00%.The mean changes in marginal bone level(mm)on the mesial side of 2.5 mm and 3.0 mm diameter implants were 0.275 ±0.638 and 0.098 ±0.31 9,distal aspects were 0.360 ±0.588 and 0.1 09 ±0.323 after 1 2 months of functional load;while 0.299 ±0.672 and 0.099 ±0.31 8,0.381 ± 0.581 and 0.1 07 ±0.31 9 after 24 months of functional load.The mesial and distal marginal bone loss of 2.5 mm diameter implant was greater than that of 3.0 mm after 1 2 and 24 months of functional load(P <0.05).No significant change on the marginal bone level was found aomog the same diameter implants from 1 2 to 24 month observation(P >0.05).No relevant complication of peri-implant soft tissue was shown.Conclusion:Favorable clinical effects including function and aesthetics can be achieved by Osstem MS one-stage implant with the diameter of 2.5 mm or 3.0 mm for the restoration of small edentulous space in the mandibular anterior region,however,the mar-ginal bone loss was greater around 2.5 mm diameter implant.

This study aimed to investigate the immune adjuvant effect and mechanism induced by chitosan nanoparticles carrying pJME/GM-CSF. In this study, plasmid DNA (pJME/GM-CSF) was encapsulated in chitosan to prepare chitosan-pJME/GM-CSF nanoparticles using a complex coacervation process. Immunohistochemistry was used to detect the type of infiltrating cells at the site of intramuscular injection. The phenotype and functional changes of splenic DCs were measured by flow cytometry after different immunogens were injected intramuscularly. The killing activity of CTLs was assessed using the lactate dehydrogenase (LDH) release assay. The preparation of chitosan-pJME/GM-CSF nanoparticles matched the expected theoretical results. Our results also found that, after pJME/GM-CSF injection, the incoming cells were a mixture of macrophages, neutrophils, and immature DCs. Meanwhile, pJME/GM-CSF increased the expression of MHC class II molecules on splenic DCs, and enhanced their Ag capture and presentation functions. Cell-mediated immunity was induced by the vaccine. Furthermore, chitosan-pJME/GM-CSF nanoparticles outperformed the administration of standard pJME/GM-CSF in terms of DC recruitment, antigen processing and presentation, and vaccine enhancement. These findings reveal that chitosan could be used as delivery vector for DNA vaccine intramuscular immunizations, and enhance pJME/GM-CSF-induced cellular immune responses.
Adjuvants, Immunologic ; administration & dosage ; Animals ; Chitosan ; administration & dosage ; immunology ; Dendritic Cells ; immunology ; virology ; Encephalitis Virus, Japanese ; genetics ; immunology ; Encephalitis, Japanese ; immunology ; prevention & control ; virology ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; administration & dosage ; genetics ; immunology ; Humans ; Immunity, Cellular ; Japanese Encephalitis Vaccines ; administration & dosage ; genetics ; immunology ; Mice ; Mice, Inbred BALB C ; Nanoparticles ; administration & dosage ; Spleen ; immunology ; T-Lymphocytes, Cytotoxic ; immunology ; virology ; Vaccines, DNA ; administration & dosage ; genetics ; immunology

Objective To present the development of the Naming test tool ( Huashan Naming Test, HNT)for Chinese cultural and by amnestic mild cognitive impairment ( aMCI ) and mild Alzheimer' s disease (AD) between the detection of memory decline,and to analyze the validity of its trial.Methods 100 normal elders from communities in Shanghai, 100 patients with amnestic mild cognitive impairment (aMCI), and 95 patients with mild Alzheimer's disease (AD) who received an education of junior high school or above and were evaluated by neuropsychological tests including mini mental state examination ( MMSE), auditory verbal memory test, Huashan Naming tests etc.8 cognitive tests.The groups of MCI and AD patients finished cranial MRI.100 items with HNT including 20 animals,10 vegetables,10 fruits ,20 tools ,20 household , 10 vehicles, 10 stationery.Results 1.HNT items to determine: 22 items were excluded due to the completion of the three groups were not significantly different; 8 items were excluded due to the completion of the normal elderly group was lower than 75%; 10 items were excluded from the analysis of variance Fvalue of the minimum value.The remaining 60 items,according to the size of the arrangement and completion rates were divided into two versions of odd and even, respectively HNT-Ⅰ and HNT-Ⅱ.2.HNT characteristics:in normal elderly group age, sex were found to had no significant factors affecting overall scores of HNT-Ⅰ and HNT-Ⅱ but level of education, MMSE score was significantly correlated (P ＜0.05).As cut-off score ≤ 26 for spontaneous naming of HNT,the sensitivities of HNT-Ⅰ for aMCI ,mild AD were 44%, 84% respectively, specificities were all around 84%; the sensitivities of HNT-Ⅱ for aMCI , mild AD were 56% ,83% respectively,specificities were all around 80%.Conclusion HNT is a Chinese cultural background,time-consuming short and good name validity test,and it is worth further promoting the application.

Adult ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Radiation, Ionizing ; Radiology Department, Hospital ; Serum ; metabolism ; radiation effects ; Testosterone ; blood ; Thyroid Hormones ; blood

Objective To find an appropriate r3diobiological model for analyzing the biological effect of the radiotherapy for breast cancer by comparing different results computed by various types of radiobiological models. Methods DVHs database simulating breast conserving radiotherapy was set up,based on clinical DVHs data of the heart.the lung and PTV of 22 patients with early breast cancer given conventional tangential radiotherapy.Two models assessing NTCP of radiation pneumonitis and cardiac mortality and four models assessing TCP were compared by analyzing the effects of the parameters and DVH database input methods on the results. Results When mean irradiation dose of the whole lung was 30 Gy.the incidence of radiation pneumonitis was 32%and 54%predicted by NTCP-RSM model and NTCP-Lyman model,respectively.When 1%cardiac mortality of radiation was assumed,28 Gy and 40 Gy isodose should cover the heart assessed by the two models.The mean TCP were 21.1%.80.8%.38.4%and 41.0%when assessed by LQ-Poisson-TCP,Zaider-TCP,Poisson-TCP and Logit-TCP models,respectively.Setting various differential DVH(dDVH)bins had very few effect on the NTCP/TCP results in a certain model.Adopting physical dose or LQED2 affected the results with greater resu]ts for physical dose.Variation in α or β value,tumor cell density and D50 had significant effect upon TCP results in LQ-Poisson-TCP(P:0.000). Conclusions NTCP-Lyman model is better for predicting the incidence of radiation pneumonitis while NTCP-RSM model is better for predicting radiation-induced cardiac mortality.LQ-Poisson-TCP is the best TCP model for clinical application.Parameters selected for model can significantly affect the results.It is imporrant to understand the distinct characteristics of different models.

Objective To investigate the social support of the elderly hospitalized individuals and its relationship with outcomes and to study its influential factors.Methods The elderly in-patients aged＞65 years old who were treated from April to June 2012 in Geriatric Department were recruited.The comprehensive geriatric assessment (CGA) that included social support scale (SSRS) was used.According to SSRS,the patients were assigned to the lower or higher score group.The participants were followed up for 1 year,and 12-month mortality and re-hospitalization were recorded.Student's t test,Chi-square test and multiple logistic regression were used for data analysis.Results The total score of social support was 26.58±8.99,which was significantly lower than the national norm (34.56±3.73,t =-7.52,P＜0.05).Those with advanced age,less household,depression,insufficient ability of daily life and instrument daily life showed relatively lower SSRS (t values were-2.54,8.22,-6.61,6.72 and 6.95,respectively; all P＜0.05).The patients with no spouse also got less social support (x2 =8.58,P＜0.05).At 1 year,no significant difference of re-hospitalization and mortality was found between the two groups (x2 values were 1.94 and 3.28,respectively; both P＞0.05).In multiple logistic regression analysis,fanily member,characteristics and living ability were the major influential factors of social support.Conclusions Medical staff should pay more attention to the elderly hospitalized patients and offer them sufficient social support to improve their quality of life.

BACKGROUND:How to reduce the incidence and mortality of cardiovascular diseases is an urgent concern in the field of public health.
OBJECTIVE:To explore the influence of adenovirus-mediated NSF-siRNA release from vesoactive substance on the cardiac function of a rat model of myocardial infarction.
METHODS:A total of 36 adult Sprague-Dawley rats were applied to establish acute myocardial infarction models by ligating the anterior descending branch of the left coronary artery. After the model was determined by electrocardiogram successful y, NSF-siRNA adenovirus (experimental group), negative adenovirus (control group) and normal saline (normal saline group) were injected near the infarct area of the left ventricle of rats respectively. After 2 weeks, the left ventricular ejection fraction (LVEF) was tested with noninvasive ultrasonic cardiogram. Meanwhile, the left ventricular end-diastolic pressure (LVEDP) and maximum pressure rising speed of left ventricular (dp/dt max) were detected by connecting the right external carotid artery place pipe to the BL-420 biological function experiment system, to evaluate the cardiac function. Subsequently, the rat heart was harvested for serial sections to observe the infarcts range.

Objective To investigate the effects of comprehensive geriatric assessment (CGA) and health intervention on outcome in discharged patients.Methods Discharged patients in geriatric ward from May to July 2012 were randomly assigned to control (n=36) and intervention (n=36) groups.Patients in the two groups were given comprehensive geriatric assessment (CGA) before discharging from hospital.Both groups were followed up for 3 months.Patients in intervention group received health intervention when leaving hospital,at 1 week,3 weeks and 3 months after discharge from hospital,while patients in control group were not given any intervention.The comprehensive illness condition (MCIRS-G),ability of daily life (ADL and IADL),rehospitalization and survival rate were compared between the two groups 3 months after the intervention.Results After 3 months,the scores of MCIRS-G,ADL and IADL were significantly better in intervention group than in control group[(29.06±4.51) vs.(33.09±4.34),(75.69±16.57)vs.(63.86±19.37),(11.72±3.20) vs.(9.77±2.52),respectively,t=3.84,2.77,2.85,all P=0.01].The total times ofreadmission and readmission length were less in intervention group than in control group [3 vs.17,x2 =8.79,P=0.02; (1.94±6.68) days vs.(8.81±14.09) days,t=2.64,P=0.01].There was no difference in survival rate between the two groups [100％ (36/36) vs.97.2％ (35/36),x2=1.01,P=0.30].Conclusions Comprehensive geriatric assessment and health intervention can alleviate symptoms and improve the ability of daily life.

Objective To study the CT characteristics of coexisting pulmonary tuberculosis and lung cancer.Methods One hundred and four patients of coexisting pulmonary tuberculosis and lung cancer proved by histology,cytology or clinical underwent CT examination.All patients were divided into two groups,group Ⅰ were the patients with the lung cancer after tuberculosis or both found simultaneously (group Ⅰ a with peripheral lung cancer and group Ⅰ b with central lung cancer),group Ⅱ with tuberculosis during lung cancer chemotherapy (group Ⅱ a with peripheral lung cancer and group Ⅱ b with central lung cancer).Imaging characteristics of tuberculosis and lung cancer were compared.x2 test and t test were used for the statistical analysis.Results Of 104 patients,there were 92 patients (88.5％) in group Ⅰ and 12 patients (11.5％)in group Ⅱ.Seventy patients (76.1％) of lung cancer and tuberculosis were located in the same lobe and 22 patients (23.9％) in the different lobes in group Ⅰ.There was no significant difference in distribution of tuberculosis between group Ⅰ and group Ⅱ (x2 =4.302,P =0.507).The fibrous stripes,nodules of calcification and pleural adhesion of tuberculosis were statistically significant between the two groups (x2 =22.737,15.193,27.792,P ＜0.05).There were 33 central lung cancers and 71 peripheral lung cancers.In group Ⅰ a (64 patients of peripheral lung cancers),39 patients (60.9％) had typical manifestations and most of the lesions were ≥ 3 cm(n =49,76.6％),solid lesions showed variable enhancement.Conclusions Secondary tuberculosis during lung cancer chemotherapy has the same CT characteristics with the common active tuberculosis.The morphology,enhancement pattern of lesion and follow-up are helpful for the diagnosis of lung cancer after tuberculosis.