ObjectiveTo understand condition about cost and economic burden of outpatients in countries and townships medical institutions in Xinjiang.MethodsThirty-one medical institution were selected and the cost and income of one-day outpatients were investigated,then the cost of different diseases,age groups and payment methods and the later disease cost burden were analyzed.ResultsOut-patient expenses of top ten common diseases was pneumonia100.12 yuan,injury 85.18 yuan,hypertension and coronary heart disease(CHD) 69.13 yuan,examination and diseases related to pregnancy 49.60 yuan,disease of the genitourinary system 41.71 yuan,enterogastrtis 34.80 yuan,bronchitis 30.72yuan,osteoarthrosis 24.60 yuan,upper respiratory infection ( URI ) 23.63 yuan,scytitis 21.14yuan;The outpatient expenses of those taking part in Neotype Countryside Cooperative Medical Care Insurance,whose family-month-income was less than 250 yuan,was 18.07 yuan,which disease cost burden was 25.56％.ConclusionThe expenses of infectious diseases in country and township hospitals was in the top ten.The cost of chronic non-communicable diseases was rising significantly;For those participating Neotype Countryside Cooperative Medical Care Insurance,the outpatient expenses was low and the disease economic burden was higher.

AS1. 398 neutral protease was immobilized onto carboxymethyl chitosan with glutaraldehyde as cross-linking agent. The effects of pH, time of cross-linking, amount of cross-linking agent and the ratio of enzyme to carrier on the activity of the immobilized enzyme were demonstrated, and the optimum immobilization condition of AS1. 398 neutral protease was established. Also studied was the characterization of immobilized enzyme,including pH, temperature, Km and the stability of storage.
Bacterial Proteins ; chemistry ; Chitosan ; analogs & derivatives ; pharmacology ; Endopeptidases ; chemistry ; Enzymes, Immobilized ; chemical synthesis ; chemistry ; Glutaral ; pharmacology ; Microspheres

Objective To observe the effect of Ziyin-Jianghuo formula in treatment of Yin deficiency generating intrinsic heat type of the levels of monoamine neurotransmitters and estrogens in rats, and investigate its intervention in the neuroendocrine system. Methods There were 7 groups, which were sham operation group, model control group, estrogen tablet group, Gengnian capsule group, Ziyin-Jianghuo formula low, medium and high dose groups. Castration was performed by castration (extraction of ovaries) plus hot traditional Chinese medicine. The rats in the treatment group were given the above drugs 24 hours after the last administration of the hot Chinese medicine, once a day for 30 consecutive days. The sham operation group and the model control group were given an equal volume of purified water by simultaneous intragastric administration. The serum estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL) levels,uterine coefficient and monoamine neurotransmitters dopamine (DA), norepinephrine (NE), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA) content in the hypothalamus were detected after 12 hours of the last treatment. Results Compared with the model group, the levels of serum FSH (4.39 ± 0.22 IU/L, 2.89 ± 0.91 IU/L, 2.84 ± 0.98 IU/L vs. 5.51 ± 0.24 IU/L), LH (14.48 ± 0.24 IU/L, 11.46 ± 0.33 IU/L, 5.28 ± 1.31 IU/L vs. 15.02 ± 0.37 IU/L) in the low, middle and high doses of Ziyin-Jianghuo formula significantly decreased (P<0.05), the levels of serum E2 (39.84 ± 6.08 pmol/L, 48.65 ± 6.77 pmol/L, 64.96 ± 7.97 pmol/L vs. 33.16 ± 4.62 pmol/L) significantly increased (P<0.05). The content of DA, 5-HT, 5-HIAA in the hypothalamus and the 5-HT/NE (0.48 ± 0.02, 0.43 ± 0.03, 0.27 ± 0.02 vs. 0.67 ± 0.02), 5-HIAA/5-HT (1.74 ± 0.09, 1.71 ± 0.10, 1.80 ± 0.17 vs. 2.00 ± 0.10) in the low, middle and high doses of Ziyin-Jianghuo formula significantly decreased ( P<0.05), the content of NE (663.34 ± 9.81 ng/kg, 695.94 ± 10.54 ng/kg, 790.76 ± 16.35 ng/kg vs. 602.95 ± 13.24 ng/kg) in the hypothalamus in the low, middle and high doses of Ziyin-Jianghuo formula significantly increased (P<0.05). The levels of serum PRL (10.16 ± 1.26 μg/L, 7.22 ± 1.26 μg/L vs. 14.80 ± 1.64 μg/L) in the middle and high doses of Ziyin-Jianghuo formula significantly decreased (P<0.05). Conclusions The Ziyin-Jianghuo formula has a significant positive regulation effect on the neuroendocrine system of menopausal Yin deficiency generating intrinsic heat type of rats, and this process is dose-dependent and can improve a series of symptoms caused by autonomic dysfunction.

OBJECTIVETo assess the association of vitamin D receptor (VDR) gene Fok I and Bsm I polymorphisms with dyslipidemia in elderly male patients with type 2 diabetes of Han nationality.

METHODSA total of 328 elderly male residents of Han nationality in Beijing, including 237 type 2 diabetic patients and 91 healthy control subjects, were enrolled in this study. The diabetic patients were divided into non-dyslipidemia group (DO group, n=134) and dyslipidemia group (DH group, n=103). All the participants were genotyped for Fok I and Bsm I polymorphisms in VDR gene using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing technology, and the results were compared with their clinical characteristics.

RESULTSFor Fok I, the frequency of F allele was significantly higher in the diabetic patients than in the control group (Χ(2)=3.873, P=0.049, OR=1.439, 95% CI: 1.001-2.071). In the dominant model, the frequency of FF genotype was significantly higher in the diabetic group (Χ(2)=5.057, P=0.025, OR=1.756, 95% CI: 1.072-2.875) as well as in DH group (Χ(2)=6.168, P=0.013, OR=2.06, 95% CI: 1.161-3.663) than in the control group. There was no significant differences in the genotype frequency or allele distribution in other paired groups (P>0.05). Compared with Ff + ff genotype, FF genotype was associated with a significantly decreased average diastolic blood pressure (P=0.039) but significantly increased postprandial blood glucose (P=0.035), triglycerides (P=0.049) and uric acid (P=0.031). No significant difference was detected in genotype frequency or allele distribution of Bsm I polymorphisms between the groups (P>0.05); serum creatinine levels were significantly higher in bb genotype than in BB + Bb genotype group (P=0.011).

CONCLUSIONVDR gene Fok I polymorphisms may be a risk factor for dyslipidemia in elderly male patients with type 2 diabetes among Chinese Han population, where Bsm I polymorphisms are not associated with diabetic dyslipdiemia.

Aged ; Alleles ; Blood Glucose ; Blood Pressure ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; genetics ; Dyslipidemias ; genetics ; Ethnic Groups ; Genotype ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Receptors, Calcitriol ; genetics ; Risk Factors ; Triglycerides ; blood

Objective: To analyze the computed tomography(CT) features and clinical outcomes of renal epithelioid angiomyolipoma(EAML). Methods: From January 2004 to June 2015, 17 patients with EAML in the Second People′s Hospital of Lianyungang and Nanjing Drum Tower Hospital were included in the study.All patients underwent CT examination.The patients' general data, imaging characteristics and pathologic features were determined by chart review. Results: Nine patients underwent radical nephrectomy, and 8 patients underwent partial nephrectomy.The mean maximal tumor diameter was 6.1 cm (ranged 1.2-12.5 cm). The fat component of one lesion was detected by CT.On unenhanced CT, the intratumoral attenuations were hyperattenuating in 9 patients, isoattenuating in 1 patient and hypoattenuating in 7 patients.The contrast enhancement degree was mild in 1 patient, moderate in 6 patients and marked in 10 patients.The contrast enhancement pattern was homogeneous in 8 lesions and heterogeneous in 9 lesions.All patients were positive for melanoma(12 cases were positive for HMB-45, 3 cases were positive for melan A, and 2 cases were positive for both). The mean follow-up period was 28.5 months (ranged 2-126 months), and 15 patients were alive with no evidence of disease at the time of the last follow-up, 1 patient exhibited local recurrence and lung metastases, and another 1 patient developed distant metastasis. Conclusion Renal EAML has a range of imaging appearances.Our data suggested that the majority of the tumors (size 10 cm) were solid and had a tendency to be hyperattenuating on unenhanced CT images.Hemorrhaging or necrosis was observed in tumors with sizes≥10cm with heterogeneous enhancement.In contrast to classic AML, which is benign, EAML is potentially malignant and exhibits aggressive clinical features, including local recurrence and distant metastasis.

Objective To assess the association of vitamin D receptor (VDR) gene Fok I and Bsm I polymorphisms with dyslipidemia in elderly male patients with type 2 diabetes of Han nationality. Methods A total of 328 elderly male residents of Han nationality in Beijing, including 237 type 2 diabetic patients and 91 healthy control subjects, were enrolled in this study. The diabetic patients were divided into non-dyslipidemia group (DO group, n=134) and dyslipidemia group (DH group, n=103). All the participants were genotyped for Fok I and Bsm I polymorphisms in VDR gene using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing technology, and the results were compared with their clinical characteristics. Results For Fok I, the frequency of F allele was significantly higher in the diabetic patients than in the control group (χ2=3.873, P=0.049, OR=1.439, 95%CI:1.001-2.071). In the dominant model, the frequency of FF genotype was significantly higher in the diabetic group (χ2=5.057, P=0.025, OR=1.756, 95%CI:1.072-2.875) as well as in DH group (χ2=6.168, P=0.013, OR=2.06, 95%CI:1.161-3.663) than in the control group. There was no significant differences in the genotype frequency or allele distribution in other paired groups (P>0.05). Compared with Ff + ff genotype, FF genotype was associated with a significantly decreased average diastolic blood pressure (P=0.039) but significantly increased postprandial blood glucose (P=0.035), triglycerides (P=0.049) and uric acid (P=0.031). No significant difference was detected in genotype frequency or allele distribution of Bsm I polymorphisms between the groups (P>0.05); serum creatinine levels were significantly higher in bb genotype than in BB + Bb genotype group (P=0.011). Conclusion VDR gene Fok I polymorphisms may be a risk factor for dyslipidemia in elderly male patients with type 2 diabetes among Chinese Han population, where Bsm I polymorphisms are not associated with diabetic dyslipdiemia.

Objective To investigate the associations of multiple immunoinflammatory markers in peripheral blood before and after operation,such as the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),lympho-cyte-to-monocyte ratio(LMR),systemic immune-inflammation index(SII)and systemic inflammatory response index(SIRI),with postoperative recurrence and metastasis in oral squamous cell carcinoma(OSCC)patients,to provide a refer-ence for predicting the prognosis of OSCC patients.Methods This study was approved by the hospital ethics commit-tee,and informed consent was obtained from the patients.A total of 160 patients with primary OSCC who underwent rad-ical surgery were grouped according to preoperative lymph node metastasis,degree of differentiation,clinical T stage,and postoperative recurrence and metastasis.The last preoperative and 1-month postoperative routine blood test results of all the patients were collected to analyze the relationship between peripheral blood inflammatory indicators,including the NLR,PLR,LMR,SII,and SIRI,before and after surgery.The above clinicopathological indicators and postoperative recurrence and metastasis were evaluated in OSCC patients.Results Among the 160 patients,there was a significant difference in the preoperative SII between the preoperative lymph node metastasis group and the no metastasis group(P＜0.05);the preoperative NLR,LMR,SII and SIRI were significantly different among the different differentiation degree groups(P＜0.05);and the preoperative SIRI in the different clinical T stage groups were significantly different(P＜0.05).The preoperative NLR,SII and SIRI were significantly different between the postoperative recurrence and metas-tasis group and the no recurrence and metastasis group(P＜0.05).Postoperative peripheral blood inflammatory markers were not associated with postoperative metastasis and recurrence.Univariate Cox analysis revealed that among the pre-operative peripheral blood inflammatory indicators,the preoperative NLR,PLR,SII and SIRI were the factors influenc-ing recurrence and metastasis in OSCC patients.Multivariate Cox analysis revealed that the preoperative NLR was the only independent risk factor for recurrence and metastasis in OSCC patients among the preoperative peripheral blood in-flammatory indicators.Conclusion Among the peripheral blood inflammatory indicators,the preoperative NLR is an independent risk factor for postoperative recurrence and metastasis in OSCC patients and has certain predictive value.

Objective To assess the association of vitamin D receptor (VDR) gene Fok I and Bsm I polymorphisms with dyslipidemia in elderly male patients with type 2 diabetes of Han nationality. Methods A total of 328 elderly male residents of Han nationality in Beijing, including 237 type 2 diabetic patients and 91 healthy control subjects, were enrolled in this study. The diabetic patients were divided into non-dyslipidemia group (DO group, n=134) and dyslipidemia group (DH group, n=103). All the participants were genotyped for Fok I and Bsm I polymorphisms in VDR gene using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing technology, and the results were compared with their clinical characteristics. Results For Fok I, the frequency of F allele was significantly higher in the diabetic patients than in the control group (χ2=3.873, P=0.049, OR=1.439, 95%CI:1.001-2.071). In the dominant model, the frequency of FF genotype was significantly higher in the diabetic group (χ2=5.057, P=0.025, OR=1.756, 95%CI:1.072-2.875) as well as in DH group (χ2=6.168, P=0.013, OR=2.06, 95%CI:1.161-3.663) than in the control group. There was no significant differences in the genotype frequency or allele distribution in other paired groups (P>0.05). Compared with Ff + ff genotype, FF genotype was associated with a significantly decreased average diastolic blood pressure (P=0.039) but significantly increased postprandial blood glucose (P=0.035), triglycerides (P=0.049) and uric acid (P=0.031). No significant difference was detected in genotype frequency or allele distribution of Bsm I polymorphisms between the groups (P>0.05); serum creatinine levels were significantly higher in bb genotype than in BB + Bb genotype group (P=0.011). Conclusion VDR gene Fok I polymorphisms may be a risk factor for dyslipidemia in elderly male patients with type 2 diabetes among Chinese Han population, where Bsm I polymorphisms are not associated with diabetic dyslipdiemia.

Objective:To investigate the clinical effect of three different tissue flaps in repairing patients with orbital region tissue loss after enlarged resection of malignant tumors in the orbital region, as well as the indication.Methods:Retrospective analysis of data of patients with malignant tumors in the orbital region treated in the Department of Oral and Maxillofacial Trauma and Orthognathic Surgery, the First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital) between January 2017 and December 2021. All patients underwent extensive resection of periorbital malignant tumors and enucleation of orbital contents, depending on defects in periorbital soft/hard tissues and orbital contents, temporalis myofascial flap combined with full thickness skin grafts (TMF-FTSG group), modified pectoralis major myocutaneous flap (PMMF group), and free anterolateral thigh flap (ALTF group) were used to repair the tissue defect. The wound healing and complications of the donor and recipient areas were followed up after operation, and degree of mouth opening in the TMF-FTSG group was compared at 3 months after operation and before operation. The University of Washington quality of life scale (UW-QOL) score was compared among the three groups before and 1 year after operation (a total of 12 items, each item was assigned from 0 to 100 points, the higher the score, the better the recovery). Statistical software SPSS 26.0 was used to analyze the data. The measurement data were expressed as Mean±SD, and the paired t-test was used to compare the preoperative and postoperative data within the group, the difference was statistically significant at a P value less than 0.05. Results:A total of 22 patients were enrolled. There were 8 patients in TMF-FTSG group, 4 males and 4 females, aged (68.3±9.7) years. There were 6 patients in PMMF group, 5 males and 1 female, aged (65.8±7.8) years. There were 3 males and 5 females in ALTF group, aged (63.8±5.4) years. There were 12 cases of squamous cell carcinoma, 8 cases of basal cell carcinoma and 2 cases of adenoid cystic carcinoma. The size of soft tissue defect after tumor resection in TMF-FTSG group, PMMF group and ALTF group was 4 cm×4 cm-7 cm×8 cm, 4 cm×5 cm-9 cm×9 cm and 5 cm×6 cm-14 cm×9 cm, respectively. And the size of flaps ranged from 5 cm×4 cm to 8 cm×9 cm, from 5 cm×7 cm to 10 cm×10 cm, and from 10 cm×6 cm to 20 cm×9 cm, respectively. All donor sites and 20 recipient sites recovered in stage Ⅰ, 2 recipient sites recovered in stage Ⅱ. The patients were monitored for a mean of (27.2 ±13.0) months. During the period of follow-up, one patient, reconstructed with PMMF, died 13 months after surgery due to local tumor recurrence, while the others did not experience metastasis or recurrence. In TMF-FTSG group, the mouth opening was (3.60±0.36) cm 3 months after operation and (3.84±0.15) cm before operation, with no significant difference ( P>0.05). The UW-QOL scores of appearance, mood and anxiety in the three groups 1 year after operation were higher than those before operation ( P<0.05), and the one year after operation’s scores of activity and shoulder were lower than those before operation ( P<0.05). The UW-QOL scores of pain and recreation in TMF-FTSG group one year after operation were higher than those before operation ( P<0.05), the other two groups were also higher than those before operation, but the difference was not statistically significant ( P>0.05). There was no significant difference in the UW-QOL scores of swallowing, chewing, speech, taste, and saliva in the three groups at one year after operation and before operation ( P>0.05). Conclusion:In the repair of tissue defects after operation of malignant tumors in the orbital region, three distinct types of tissue flaps can be utilized to repair tissue defects. TMF-FTSG has certain advantages for patients with minor bone defects, whereas ALTF and PMMF are more appropriate for patients with extensive tissue loss. PMMF is an effective method of repair for patients with a history of radiotherapy and poor vascular health in the recipient area.

Objective:To investigate the clinical effect of three different tissue flaps in repairing patients with orbital region tissue loss after enlarged resection of malignant tumors in the orbital region, as well as the indication.Methods:Retrospective analysis of data of patients with malignant tumors in the orbital region treated in the Department of Oral and Maxillofacial Trauma and Orthognathic Surgery, the First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatological Hospital) between January 2017 and December 2021. All patients underwent extensive resection of periorbital malignant tumors and enucleation of orbital contents, depending on defects in periorbital soft/hard tissues and orbital contents, temporalis myofascial flap combined with full thickness skin grafts (TMF-FTSG group), modified pectoralis major myocutaneous flap (PMMF group), and free anterolateral thigh flap (ALTF group) were used to repair the tissue defect. The wound healing and complications of the donor and recipient areas were followed up after operation, and degree of mouth opening in the TMF-FTSG group was compared at 3 months after operation and before operation. The University of Washington quality of life scale (UW-QOL) score was compared among the three groups before and 1 year after operation (a total of 12 items, each item was assigned from 0 to 100 points, the higher the score, the better the recovery). Statistical software SPSS 26.0 was used to analyze the data. The measurement data were expressed as Mean±SD, and the paired t-test was used to compare the preoperative and postoperative data within the group, the difference was statistically significant at a P value less than 0.05. Results:A total of 22 patients were enrolled. There were 8 patients in TMF-FTSG group, 4 males and 4 females, aged (68.3±9.7) years. There were 6 patients in PMMF group, 5 males and 1 female, aged (65.8±7.8) years. There were 3 males and 5 females in ALTF group, aged (63.8±5.4) years. There were 12 cases of squamous cell carcinoma, 8 cases of basal cell carcinoma and 2 cases of adenoid cystic carcinoma. The size of soft tissue defect after tumor resection in TMF-FTSG group, PMMF group and ALTF group was 4 cm×4 cm-7 cm×8 cm, 4 cm×5 cm-9 cm×9 cm and 5 cm×6 cm-14 cm×9 cm, respectively. And the size of flaps ranged from 5 cm×4 cm to 8 cm×9 cm, from 5 cm×7 cm to 10 cm×10 cm, and from 10 cm×6 cm to 20 cm×9 cm, respectively. All donor sites and 20 recipient sites recovered in stage Ⅰ, 2 recipient sites recovered in stage Ⅱ. The patients were monitored for a mean of (27.2 ±13.0) months. During the period of follow-up, one patient, reconstructed with PMMF, died 13 months after surgery due to local tumor recurrence, while the others did not experience metastasis or recurrence. In TMF-FTSG group, the mouth opening was (3.60±0.36) cm 3 months after operation and (3.84±0.15) cm before operation, with no significant difference ( P>0.05). The UW-QOL scores of appearance, mood and anxiety in the three groups 1 year after operation were higher than those before operation ( P<0.05), and the one year after operation’s scores of activity and shoulder were lower than those before operation ( P<0.05). The UW-QOL scores of pain and recreation in TMF-FTSG group one year after operation were higher than those before operation ( P<0.05), the other two groups were also higher than those before operation, but the difference was not statistically significant ( P>0.05). There was no significant difference in the UW-QOL scores of swallowing, chewing, speech, taste, and saliva in the three groups at one year after operation and before operation ( P>0.05). Conclusion:In the repair of tissue defects after operation of malignant tumors in the orbital region, three distinct types of tissue flaps can be utilized to repair tissue defects. TMF-FTSG has certain advantages for patients with minor bone defects, whereas ALTF and PMMF are more appropriate for patients with extensive tissue loss. PMMF is an effective method of repair for patients with a history of radiotherapy and poor vascular health in the recipient area.