It is always an important academic and policy issue to understand the impact of hospital distance on Chinese inpatient service demand in rural areas. It employs household survey data collected from 97 villages in Shandong in 2006 and 2008, and investigates the influences of hospital distance on the demand of famars in rural areas. The discrete choice model is constructed to estimate the inpatient service demand function for patients in rural areas. The empirical analysis finds that the hospital distance is significantly affecting Chinese inpatient service demand in the rural areas. The longer the distance increases, the lower the visiting rate drops. In addition, the impact changes with the changes of hospital level; the lower the primary hospital is, the higher the impact would be. It paper provides new evidence for the understanding of the geographical characteristics of medical health care.

It is a well-recognized difficult empirical task to disentangle the moral hazard effect from adverse selection impact by using the health insurance data in the empirical research of health economics. In the research, the unique social experiment in China’s health care reform, which enables cleanly identify moral hazard is applied. Using individual-level hospital patient data, it estimates the impact of the reimbursement rate increase on Chinese patients’ demand for health care service. Difference-in-Difference Propensity Score Matching approach and find strong evidence for moral hazard are approached. For instance: if the reimbursement rate increases by 5% while other factors remain the same, the corresponding health care service expenditure will increase by around 7%. The finding also has important implication for policy making. Chinese government pledges to lower the average individual out-of-pocket cost from the current 37.5% of total health care service cost to 30 % in 5 years. According to the former estimation, if the goal of the policy is successfully achieved, moral hazard problem itself will cost Chinese health care system around 200 billion yuan.

Objective To establish a method of PKH26 labeled bone marrow-derived endothelial progenitor cells (EPCs) into rats with liver fibrosis and observe cell immigration and differentiation in the liver after transplantation.Methods Bone marrow-derived EPCs were isolated and cultured from rats with liver fibrosis,and then labeled with PKH26 in vitro.Under the scanning confocal microscopy and flow cytometry,PKH26 fluorescent labeling rate and cell survival rate were measured.EPCs of PKH26 fluorescent labeling were transplanted into rats with liver fibrosis via the tail vein,and the migration situation was observed in the liver.Endothelial cell markers CD31 and von willebrand factor (vWF) were detected by using immunofluorescence.Results The PKH26-labeled EPCs appeared red fluorescence and the labeling rate was 96.65 ％.As compared with unlabeled cells,the labeled cells grew well,and had no significant changes in the growth curve.After transplantation into the liver of rats,the PKH26 labeled cells were mainly distributed in blood vessel endothelium along fibers and hepatic sinusoids in hepatic lobule.Endothelial cell-specific antigens such as CD31 and vWF could be detected along the vascular walls.Conclusion PKH26 could be used to label and track EPCs in the liver of rats with liver fibrosis in vitro.The PKH26-labeled cells may migrate to the surrounding of the hepatic vessels and differentiate into mature endothelial cells.

Objective To obtain imaging information of the cervical arteries and vertebral structure of rhesus ma -caques and provide useful reference data for medical research works using macaques as animal models .Methods Six a-dult macaques (3 males and 3 females) in age of 3-5 years, body weight from 3.5 to 5 kg, were used to examine the neck by 320 row spiral CT imaging under general anesthesia , and three-dimensional reconstruction was performed to observe the vertebral artery morphology , and to measure the diameter of vertebral artery and the size of transverse foramen of the ma -caques .Color Doppler ultrasound was combined with 320-CT imaging to assess the blood flow velocity in carotid arteries . After CT scan to make sure that the vertebral artery and cervical vertebra of macaques had no deformity , the size of trans-verse foramen and diameter of vertebral artery were measured in the cross-sectional images .Color Doppler ultrasound was used to analyze the peak systolic velocity ( PSV) , diastolic peak flow velocity ( EDV) and the diameter ( D) of common ca-rotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), and vertebral artery (VA) of the ma-caques .Results The 320-CT scan showed that in the monkeys , the vertebral artery enters the cervical spine through the intervertebral foramina at C6, and leaves the cervical spine at C 2 level, and the cervical spine has Luschka joint , which is similar to the anatomic structure in humans .The diameter of left and right vertebral arteries was 1.89 ±0.44 mm and 1.72 ±0.39 mm, respectively , with no significant difference between them in the same segment ( P>0.05 ) , and the size of transverse foramen also had no significant difference in the same segment ( P>0.05 ) .Color Doppler ultrasound showed that the left and right side systolic peak velocity (PSV) and diastolic peak velocity (EDV) of CCA and ICA, the left and right side systolic peak velocity (PSV) of ECA and VA had statistically significant difference (P<0.05), and the left ar-teries were predominant in the macaques .Conclusions In this study we obtained some imaging information of vertebral artery morphology and artery blood flow of macaques and these information may provide some useful basic data for further studies using rhesus macaques as animal models .

Objective To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with gabapentin for treatment of recurrent pain after trigeminal radiofrequency thermocoagulation.Methods Forty patients of both sexes suffering from recurrent pain after trigeminal radiofrequency thermocoagulation,who refused surgical treatment,aged 45-80 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with visual analog scale score ≥4,with the course of recurrent pain 0.5-17.0 months,were randomized into 2 groups (n =20 each) using a random number table:gabapentin group (group A) and gabapentin plus rTMS group (group B).The patients were treated with 2 courses of rTMS in total (5 days for 1 course,1 time per day) and with the second course at a 2-day interval in group B.Effective analgesia and pain relief were recorded within 6 months after treatment,and the therapeutic efficacy was evaluated according to the modified Macnab criteria.The daily consumption of gabapentin and development of rTMS-and gabapentin-related adverse reactions were recorded.Results No rTMS-related adverse reactions were found in group B.Compared with group A,the rates of effective analgesia and pain relief were significantly increased,the therapeutic efficacy was enhanced,the daily consumption of gabapentin was decreased,and the incidence of gabapentin-related adverse reactions was decreased in group B (P＜0.05).Conclusion Combination of rTMS and gabapentin produces better efficacy than gabapentin alone when used to treat the recurrent pain after trigeminal radiofrequency thermocoagulation,and the safety is good.

ObjectiveTo observe the effect of comprehensive therapy on forearm extensor myotenositis.Methods72 cases were divided into two groups: a control group of 36 cases who were given routine treatment,and an experiment group of 36 cases who were given thermotherapy,computerized medium-frequency electrotherapy,physiotherapy,and ADL instruction,etc.After two courses,a simple grading score(for forearms) was used to assess the effect.ResultsOf the control group,22 cases were cured,10 remarkably effective,4 effective;of the experiment,30 cured,4 remarkably effective,2 effective(u=2.04, P<0.05).The difference of average score for forearms before and after the treatment were(6.58±3.17) points for the control and(8.19±3.55) for the experiment(t=2.03,P<0.05).The average days of cure were(5.60±2.54) d for the experiment group,shorter than those for the control(7.00±2.27) d(t=2.05,P<0.05).ConclusionComprehensive therapy is effective on forearm extensor myotenositis.

The effect of magnetic Fe3O4 particles on cellulase in the enzymatic hydrolysis of sunflower seed hull was studied in different adding ways and additive amount. In the process of enzymatic hydrolysis of sunflower seed hull, the variations of cellulase activity, reducing sugar concentration and cellulose conversion were evaluated. After the reaction, the analysis of pH and surface tension of hydrolysate were also used to determine the mechanisms of cellulase by the magnetic effect. The results indicated that after adding magnetic Fe3O4, the cellulase activity, reducing sugar concentration and conversion of cellulose had an increased between the 0.5 g/L and 2.0 g/L cases after 48 h. When the additive amount of magnetic Fe3O4 was 2 g/L, the cellulase activity at 60 h was improved significantly by 25.9%. It was found that the concentration of reducing sugar was increased from 6.950 mg/mL to 8.775 mg/mL with magnetic Fe3O4 1.5 g/L. Simultaneously, compared with the blank, which the conversion of cellulose was 47.932%, the maximum celluloseconversion of samples with adding magnetic Fe3O4 was 60.531%. Besides, the stability of cellulase activity adding in times was better than in one time. After the reaction, the final surface tension of hydrolysate with 1.5 g/L magnetic Fe3O4 was the lowest in comparison with the blank. However, no significant differences were observed in the final pH of the hydrolysate.

OBJECTIVETo explore the action mechanism of Tongxinluo Capsule (TXL) in protecting brain from ischemic damage.

METHODSSD rats were divided into five groups randomly, the sham operation group, the model group, the MK-801 group, the large and low dosage TXL groups (TXLL and TXLS). After the middle cerebral arterial obstructive (MCAO) model was established, peritoneal injection of MK-801 0.5 mg/kg per day was given to the MK-801 group, and 1.0 g/(kg x d) and 0.5 g/(kg x d) of TXL powder was administered in twice via gastrogavage to the two TXL groups respectively. The nerve cell apoptosis rate, protein and mRNA expressions of Caspase-3, p53 and heat shock protein (HSP70) were observed using flow cytometry, Western blot and RT-PCR technique.

RESULTSBoth TXL and MK-801 could obviously lower the apoptosis rate in model rat (P < 0.05, P < 0.01), TXLL showed the optimal effect. Caspase-3, p53 protein and mRNA expression in the model group were obviously higher than those in the sham operated group. As compared with the model group, the expressions of Caspase-3 and p53 were lower and those of HSP70 and mRNA were higher in the two TXL and MK-801 groups (P < 0.05 or P < 0.01).

CONCLUSIONTXL displays it brain protective effect through reducing nerve cell apoptosis rate in MCAO model rats, the mechanism may be related to its actions in inhibiting apoptosis related factors Caspase-3 and p53, and promoting stress protecting factor HSP70.

Animals ; Apoptosis ; drug effects ; Arterial Occlusive Diseases ; etiology ; physiopathology ; Blotting, Western ; Brain Ischemia ; complications ; Capsules ; Caspase 3 ; biosynthesis ; genetics ; Cerebral Arteries ; pathology ; physiopathology ; Disease Models, Animal ; Dizocilpine Maleate ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Male ; Neurons ; drug effects ; metabolism ; pathology ; Neuroprotective Agents ; therapeutic use ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Suppressor Protein p53 ; biosynthesis ; genetics

OBJECTIVETo study the change of lymphocyte subgroups in the peripheral blood of patients with gastric carcinoma and its association with survival.

METHODSFlow cytometry was used to examine the subgroups of lymphocytes (CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+), CD19(+), CD25(+), CD44(+) and NK cells) in the peripheral blood of 833 gastric carcinoma patients prior to any therapy. Patients were divided into the high expression group and lower expression group according to the average test values of 96 healthy control subjects. Survival rate was compared between the two groups.

RESULTSCompared with control group, the levels of CD3(+) and CD8(+) T cell in patients were significantly lower, while the levels of CD4(+), CD19(+), CD25(+), CD4(+)/CD8(+), CD44(+), and NK(+) cells were significantly. The differences were statistically significant(P<0.05). Three-year survival rates of gastric cancer patients with high CD19(+) expression (n=444) and cases with low CD19(+) expression (n=389) were 36.4% and 18.5%, respectively(P<0.05). The expressions of other seven types of lymphocytes were not associated with survival rates (all P>0.05).

CONCLUSIONSSignificant changes in lymphocyte subgroups exist in the peripheral blood of patients with gastric carcinoma. Patients with high CD19(+) expression have better survival.

Adult ; Aged ; CD4-Positive T-Lymphocytes ; CD8-Positive T-Lymphocytes ; Case-Control Studies ; Female ; Flow Cytometry ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Stomach Neoplasms ; blood ; mortality ; pathology ; Survival Rate ; T-Lymphocyte Subsets

0.05).Conclusions The SCIO system is practical to assess the therapeutic effects of itraconazole and terbinafine for patients with onychomycosis.Treatment of onychomycosis with the two drugs is equally effective and safe.