Objective: To study the status and identify the determinants of outpatient service utilization of rural floating population in Beijing who have different accumulated residence time.Methods: The survey data of rural floating population health and health care services in Beijing in 2014 were used, and the migrant population aged 18 years and above were taken as the research object.Whether to use outpatient service within two weeks was taken as dependent variable, gender, age, education level, self-assessment score of socioeconomic status, accumulated residence time in Beijing, health insurance, average household income, suffering from high blood pressure or diabetes as independent variables.Logistic regression model was used to analyze the influencing factors.Results: The average age of the research object was 36.7 years, with mostly secondary education.The average accumulated residence time in Beijing was 8.4 years.The two-week prevalence rate was 10.3%, the two-week visiting rate calculated by person-time was 6.0%.The Logistic regression model suggested that, socioeconomic status, accumulated residence time and suffering from high blood pressure or diabetes were statistically significant determinants of outpatient service utilization.Conclusion: The research object is a younger and less educated population, their health status is better and outpatient service utilization is lower.It is found that people who have longer accumulated residence time in Beijing have lower outpatient service utilization.This is because people with longer residence time have lower age-adjusted two-week prevalence rate.This is also because people with longer residence time have larger proportion of taking continuous measures under doctor's advice.It does not mean people with longer residence time have lower utilization of medical service.The residence time variable plays the role of proxy variable.It can solve the problem of variables' endoge-neity.At the same time, it can reflect the influence to outpatient services utilization of some determinants,which are not included in the model but varies with residence time.

Ossification of the posterior longitudinal ligament (OPLL) is common clinical spinal disorders often occurring in the cervical spine,with the main symptom being nerve compression.The specific mechanism of OPLL remains unclear,but genetic factors,single nucleotide polymorphisms (SNPs),mechanical stimulation,metabolism abnormality might be involved in the etiology of the disease.Multiple genetic and environmental factors may contribute to the development of OPLL.OPLL has prominent genetic characteristic,and it is associated with SNPs of several genes.Here we review the SNPs of several genes (COL11A2,BMP-2,TGF-?1,TGF-?3,NPPS,COL6A1 and Runx2) which contribute to the development of OPLL,hoping to lay a foundation for future study.

Objective To construct the luciferase reporter gene vector of cell division cycle 2 (Cdc2) gene promoter and determine its transcriptional activity. Methods Primers were designed based on human Cdc2 promoter sequence from UCSC software. Then Cdc2 promoter from human genome DNA was replicated. After pGL3-Basic vector and Cdc2 promoter were digested with restriction enzymes SacⅠand XhoⅠseparately, Cdc2 promoter was inserted into pGL3-Basic vector. The recombinant plasmid named pGL3-Cdc2-promoter was transiently co-transfected into U2OS cells with control vector pRL-SV40, and then the activity of dual luciferase was detected. Results pGL3-Cdc2-promoter was constructed successfully. The restriction analysis and sequencing proved the entirely correct sequencing results. The luciferase activity was higher in pGL3-Cdc2-promoter/pRL-SV40 group than that of pGL3-Basic/pRL-SV40 group (1.591 5±0.199 8 vs 0.049 9±0.010 4). Conclusion pGL3-Cdc2-promoter can be transcribed and activated in U2OS cells. This study provided an important basis for screening and evaluation of anticancer drugs.

Tyrosine kinase inhibitors (TKIs) are used as the primary first-line treatment for advanced hepatocellular carcinoma, and the combination of immune checkpoint inhibitors (ICIs) and angiogenesis inhibitors have also been recommended as first-line treatment recently. For hepatocellular carcinoma patients with portal vein tumor thrombus, hepatic artery infusion chemotherapy (HAIC) is supported by progressively more evidence in improvement in the overall survival benefit. Based on relevant literatures and combined with clinical practices, the authors investigate the clinical application and development trends of TKIs, ICIs and HAIC in the first-line treatment for advanced hepatocellular carcinoma.

Objective To research the early effects and side-effects of the local advanced nasopharyngeal carcinoma patients using intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy.Methods From January 2005 to January 2007,60 patients with nasopharyngeal carcinoma of stage m-IV b were received IMRT combined with concurrent chemotherapy in our center.Sixty patients were divided into paclitaxel concurrent group(32 patients)and cisplatin concurrent group(28 patients).The prescribing doses of the primary tumor were 68-72 Gy for each group.The patients of paclitaxel concurrent group patients of the cisplatin concurrent group got earlier radiodennatitis and radiation-induced mucositis but also got significantly higher rate of radiodermatitis,radiation-induced mucositis,radiation-induced leucopenia and gastrointestinal toxicity,as well as the loss of weight.No significant difference was found on liver and renal funcfons between two groups.Four patients(12.5%)of the paclitaxel concurrent group were broken-off,which was much better than the cisplatin concurrent group.There was no significant difference on the specific length of break-off time,the 2-year overall survival rate and the 2-year diseaee-free survival rate between two groups.Conclusions IMRT combined with concurrent chemotherapy of paclitaxel liposome for local advanced nasopharyngeal carcinoma results in less side-effects and better tolerance than IMRT combined with concurrent cisplatin chemotherapy.

Objective To evaluate DSA and MRI in diagnosing focal nodular hyperplasia(FNH) of the liver.Methods DSA and MRI findings in seven patients with pathologically-proved FNH were retrospectively analyzed.Selective hepatic arteriography with DSA,and both plain and dynamic contrastenhanced MR scans were performed in all patients.The imaging findings were retrospectively evaluated and analyzed.Results On DSA examination,all FNH lesions were hyper-vascular,which were characterized by thickened and tortuous feeding arteries.And the feeding arteries,after entering the lesions,branched off peripherally in a radiation pattern and the lesions were evenly dyed with sharp borders.In venous phase,hepatic vein drainage was demonstrated in 6 cases.On dynamic contrast-enhanced MRI,marked enhancement of the lesions was observed,which lasted until to delayed phase when the lesions still showed hyper-intensity or iso-intensity signals.Scar signal in the lesion's center was seen in three cases,which started to enhance at portal vein phase and maintained to delayed phase.Conclusion On DSA imaging,FNH lesions are characterized by thickened and tortuous feeding arteries that branch off peripherally in a radiation pattern after entering the lesions.And the hepatic vein drainage is also a common finding in venous phase.Dynamic contrast-enhanced MRI can well display the abnormal signal of the central scar of FNH.The combination use of DSA and MRI can effectively improve the diagnostic accuracy for FNH.

Objective To study CT features of thymoma,so that to improve the accuracy of CT diagnosis and differential diagnosis.Methods 31 cases of thymomas proved by surgery and pathology were examined with conventional CT scans.CT findings of thymoma were analyzed.Results The lesions in 27 cases(87.1%)were located in the anterior upper and middle mediastinum.There were benign lesion in 11,including mass-cardiovascular interface(MCI) with convex type(8 cases),flatness type(1 cases) and concave type(2 cases).20 cases were malignant lesion,including MCI with cast type(18 cases) and concave type(2 cases).Irregular invasion to adjacent organs was found in 11 cases,others included pericardiac effusion(n=6),pericardial and mediastinal invasion(n=2),pleural effusion(n=4),pneumonia(n=2),lung,bone,mediastinal lymphadens metastasis(n=2) and liver,pancreas metastasis(n=1).Conclusion CT scans is of significant value in diagnosis and differential diagnosis of thymoma.

BACKGROUND: Epidemiologic studies have shown an association between higher insulin levels and coronary artery disease, and metabolic studies have associated insulin resistance and compensatory hyperinsulinemia with non-insulin-dependent diabetes mellitus, hypertension, obesity,and lipid disorders.OBJECTIVE: To investigate the relationship between insulin resistance (IR) and erythrocyte insulin receptors (EIRs) in the patients with cerebral infarction (CI).DESIGN: Case-control trial.SETTING: Department of Neurology, China-Japan Union Hospital of Jilin University.PARTICIPANTS: From January 2004 to October 2004, 40 patients with CI, who were in-patients in China-Japan Union Hospital of Jilin University,were selected for the study. Meanwhile, 30 healthy doctors or nurses were recruited as normal controls.METHODS: The levels of blood glucose and serum insulin under fasting and 2-hour after oral glucose tolerance test (OGTT) were detected in the 40 patients with CI and 30 healthy doctors or nurses. Fasting blood glucose multiplied by fasting serum insulin was insulin resistance index (IRI). The number of insulin receptors and their binding affinity on every erythrocyte were determined using modified Gambhir's method. The correlation between the number of EIRs and IRI was analyzed.MAIN OUTCOME MEASURES: Comparison of CI group with controlRESULTS: Data of 40 patients with CI and 30 controls were analyzed, and under fasting and 2-hour after OGTT: The level of serum insulin under fasting and blood glucose, serum insulin at 2-hour after OGTT in CI group were higher than those in normal group [(13.30±5.15), (9.85±4.36) mU/L,(8.27±1.65), (6.32±1.37) mmol/L, (75.21±21.12), (28.26±6.31)mU/L,P ＜ 0.01,EIRs: The number of insulin receptors with high and low affinity and maximum specific binding rate in the patients with CI were significantly less than those in normal group [20.30±4.50, 23.80±4.10; 2 223.80±509.30,2 610.10±435.10; (10.62±3.55)%, (13.21±2.94)%, P ＜ 0.01]. Multiple linear regression analysis and correlation analysis showed the numbers of two types of EIRs in the patients with CI were negatively correlated with IRI (r=-0.458, -0.439, P ＜ 0.01, both).CONCLUSION: Insulin resistance can lead to cerebral infarction. Decrease in insulin receptors may play an importance role in cerebral infarction induced by insulin resistance.

Objective To explore how to improve the sensitivity and specificity of CT cisternography (CTC) examination.Methods The clinical data of 20 cases of CTC in detecting cerebrospinal fluid rhinorrhea were analyzed,and the influence of continuous dripping of fluid and the filling time of subarachnoid space upon the image quality were observed.Results Nineteen cases of active cerebrospinal fluid rhinorrhea were found with CTC,and the fistula sites were determined by CTC.Eighteen cases received operation which confirmed the fistula sites.One case was found with no active fistula site.According to the image of ethmoid sinus leaks results,7 cases had better image quality in 9 cases whose subarachnoid space filling time was longer than or equal to 10 min.One case had better image quality in 6 cases whose subarachnoid space filling time was shorter than 10 min.There was significant difference (P =0.0406).Conclusion To raise the positive rate of CTC,the position of active fistula should be maintained and keep the time between the injection and scan longer than or equal to 10 min,which help to get better image quality.

Objective To Analyze the development tendency and major influential factors of the resource and service of traditional medicine (TM) by contrasting the statistical data between China and India.Methods The research data came from the governmental statistical date of traditional medicine.The main statistical indicators included:number of TM hospitals,number of beds in TM institutions,number of health personnel of TM,number of visits and inpatients of TM institutions.A contrastive analysis was given based on these data over the period of 2008-2012.Results In 2012,the number of traditional Chinese medicine (TCM) hospital per ten million populations was 25.1,the number of Traditional Indian Medicine (TIM) hospital per ten million populations was 25.9; the number of beds in TCM institutions per ten thousand populations was 4.5,the number of beds in TIM institutions per ten thousand populations was 0.5; the number of TCM physicians and physician assistants per ten thousand populations was 2.6,the number of TIM physicians and physician assistants per ten thousand populations was 5.9.In 2012,the numbers of visits and inpatients of governmental public TCM hospitals were 426.671 million and 16.882 million; the numbers of visits and inpatients of governmental public TIM hospitals were 73.445 million and 0.947 million.Conclusion There was no significant difference in the number of TM hospitals per ten million populations between China and India.China had obviously advantages in the number of beds in TM institutions,number of visits and inpatients of TM institution.India had obviously advantages in the number of TM health personnel.