BACKGROUNDThe peritoneal dialysis (PD) therapy for end stage renal disease (ESRD) is expensive. The main reason for non-acceptance onto dialysis programs is the great cost. In the present study, we design an auxiliary business insurance program to provide the potential ESRD patients who have no access to governmental medical insurance or can not afford the remaining part besides the limited reimbursement for peritoneal dialysis therapy.

METHODSThe information applied in this study was extracted from the medical records of 641 PD patients, who were treated in two dialysis centers of the first and the third teaching hospitals of the Peking University respectively. A collective risk model was employed to estimate the expenses on PD therapy. Survival analyses were performed to obtain the average survival time of PD patients and the average length of time from the onset of the primary disease to the beginning of PD. An annuity method was used to determine the pure premium.

RESULTSFor chronic nephritis, diabetes mellitus and hyperpietic as primary diseases, the mean survival time +/- standard errors were (55.1 +/- 3.7) months, (38.9 +/- 3.2) months and (61.4 +/- 4.6) months respectively, and they were significantly different from each other (all P = 0.000). The expenses of whole PD therapy were 242 159.05 Yuan, 182 525.02 Yuan and 284 579.24 Yuan respectively.

CONCLUSIONSAn auxiliary business insurance for PD patients was designed with the pure premium for any individual who had chronic nephritis, diabetes mellitus or hyperpietic as primary disease was RMB 35.94 Yuan/year, 87.73 Yuan/year or 7.71 Yuan/year respectively without considering the additional premium for coping with the business expenditures and accidental risks.

Adult ; Aged ; Female ; Humans ; Insurance, Health ; Male ; Middle Aged ; Peritoneal Dialysis ; economics ; mortality

Five field strains of infectious bronchitis virus (IBV) were isolated from suspected flocks from different time and different regions of Shanxi province,respectively,and characterized by a series of systematic identification assays,such as morphological observation by electron-microscope,interfering with the propagation of NDV,virus pathological role to chicken embryo,virus pathological role to SPF chickens,hemagglutination activity,physiscochemical,and reverse transcription polymerase chain reaction(RT-PCR).The results showed:The typical coronavirus which the spherical virions 60-120 nm in diameter and surface covered with spike like corona were observed under electron-microscope)The propagation of NDV strain was seriously interfered by the 5 isolates respectively;The embryonated chicken egg passages of the 5 isolates could dwarf with chicken embryos;The five isolates had no hemagglutination activity,but after treatment with 1% trypsin,it can agglutinate chicken red blood cell.The strains are sensitive to chloroform and ethyl ether.The SPF chickens which inoculated with the 5 isolates showed clinical sign and result in respiratory and kidney diseases,flower-steak,and swollen with severe urate deposition.The specific fragments of N gene of the 5 isolates were amplified by RT-PCR,respectiveiy.On the basis of all above mentioned results,the 5 isolates were classified as IBV.The study got a good preparedness for further study on molecular epidemioogy of the 5 IBV isolates.

Diabetes Mellitus ; economics ; Hospitalization ; Humans ; Insurance Claim Review ; Insurance, Health ; Normal Distribution ; Probability ; Risk

OBJECTIVETo construct a eukaryotic expression vector encoding the gene of extracellular region of mouse B7-H4, to express it in yeast cell line and to determine its biological activity.

METHODSThe extracellular region of the mouse B7-H4 gene was amplified with Xho I and EcoR I by PCR from a mouse B7-H4 chimeric plasmid. Digested with Xho I and EcoR I, the mB7-H4 gene was inserted into the yeast expression plasmid Ppic9. The DNA sequence was confirmed by double digestion and the Ppic9-mB7-H4 plasmid was transfected into the yeast cells. The expression of mB7-H4 was confirmed by PCR, Western Blot and ELISA analysis, and its biological function was determined.

RESULTPpic9-mB7-H4 transfectants expressed mB7-H4 in yeast cells, and mB7-H4 effectively inhibited the proliferation of T lymphocytes with a fractional inhibition rate of 28.3 % and inhibited IL-2, IL-4, IL-10 and IFN-gamma production with fractional inhibition rates of 68.8%, 78.8%, 67.6% and 77.7%, respectively.

CONCLUSIONThe eukaryotic expression plasmid mouse B7-H4 has been successfully constructed and the expressed products of B7-H4 possess biological activity.

Animals ; B7-1 Antigen ; biosynthesis ; genetics ; Mice ; Pichia ; genetics ; metabolism ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; T-Lymphocytes ; immunology ; V-Set Domain-Containing T-Cell Activation Inhibitor 1

OBJECTIVETo assess the prevalence of pre-hypertension and hypertension as well as the association with overweight/obesity in Shanghai adolescents.

METHODSSchool children aged 11 - 17 years in four schools in Shanghai were included in this survey. All students were visited in May 2010 at school by trained nurses or physicians who administered a questionnaire and carried out anthropometric measurements. Anthropometric measurements included height, weight, heart rate and blood pressure. Repeat measurements were performed in school children with elevated blood pressure within one month. The pre-hypertension and hypertension was defined on the basis of the 2004 National High Blood Pressure Education Program Working Group definitions. The overweight and obesity was defined using cutoff points recommended by Working Group of Obesity, China (WGOC).

RESULTSThere were 4175 school children aged 11 - 17 years [mean (15.0 ± 1.9) years, 52.3% (n = 2183) girls and 47.7% (n = 1992) boys]. There were 72.5% (n = 3025) participants with normal blood pressure [ girls (n = 1666) 76.3% and boys (n = 1361) 68.3%], 18.0% (n = 750)participants with pre-hypertension [14.2% (n = 310) for girls and 22.1% (n = 440) for boys], 8.3% (n = 346) participants with stage 1 hypertension [8.2% (n = 179) for girls and 8.3% (n = 165) for boys] and 1.3% (n = 54) participants with stage 2 hypertension [1.3% (n = 28) for girls and 1.3% (n = 26) for boys]. The prevalence of overweight and obesity was 6.7% (n = 147) and 3.0% (n = 66) for girls and 13.7% (n = 273) and 6.3% (n = 125) for boys. After adjusting for gender, age, parental history of hypertension and physical activities, multivariable logistic regression analysis showed that the overweight [adjusted odds ratio and 95% confidence interval: 1.42 (1.16 - 1.75)] and obesity [adjusted odds ratio and 95% confidence interval: 2.35 (1.78 - 3.11)] were independent predictors of elevated blood pressure in this cohort.

CONCLUSIONSThe prevalence of elevated blood pressure is common in adolescents in Shanghai. Overweight and obesity are closely associated with the elevated blood pressure in this cohort.

Adolescent ; Child ; China ; epidemiology ; Epidemiological Monitoring ; Female ; Humans ; Hypertension ; epidemiology ; Male ; Obesity ; epidemiology ; Overweight ; epidemiology ; Prevalence ; Risk Factors

BACKGROUNDBrain-derived neurotrophic factor (BDNF) is a stress-responsive intercellular messenger modifying hypothalamic-pituitary-adrenal (HPA) axis activity. The interaction between stress and age in BDNF expression is currently not fully understood. This study was conducted to observe unpredictable stress effect on behavior and BDNF expression in CA3 subfield (CA3) and dentate gyrus of hippocampus in different aged rats.

METHODSForty-eight Wistar rats of two different ages (2 months and 15 months) were randomly assigned to six groups: two control groups and four stress groups. The rats in the stress group received three weeks of unpredictable mild stress. The depression state and the stress level of the animals were determined by sucrose preference test and observation of exploratory behavior in an open field (OF) test. The expressions of BDNF in CA3 and dentate gyrus of the hippocampus were measured using immunohistochemistry.

RESULTSAge and stress had different effects on the behavior of different aged animals (age: F = 6.173, P < 0.05, stress: F = 6.056, P < 0.05). Stress was the main factor affecting sucrose preference (F = 123.608, P < 0.05). Decreased sucrose preference and suppressed behavior emerged directly following stress, lasting to at least the eighth day after stress in young animals (P < 0.05). The older stress rats showed a lower sucrose preference than young stress rats (P < 0.05). Older control rats behaved differently from the younger control animals in the OF test, spending more time in the central square (P < 0.05), exhibiting fewer vertical movements (P < 0.05) and less grooming (P < 0.05). Following exposure to stress, older-aged rats showed no obvious changes in vertical movement and grooming. This indicates that aged rats were in an unexcited state before the stress period, and responded less to stressful stimuli than younger rats. There was significantly lower BDNF expression in the CA3 and dentate gyrus regions of the hippocampus following stress in both age groups (P < 0.05), a reduction that was still present at the eighth day after stress (P < 0.05). Stress and age were the main factors affecting the expression of BDNF (F = 9.408, P < 0.05; F = 106.303, P < 0.05). The aged stress group showed lower BDNF expression compared to the young stressed group at every testing time point.

CONCLUSIONStress has age-dependent effects on behavioral responses and hippocampal BDNF expression in rats.

Age Factors ; Animals ; Behavior, Animal ; Brain-Derived Neurotrophic Factor ; analysis ; genetics ; Chronic Disease ; Dentate Gyrus ; chemistry ; Exploratory Behavior ; Hippocampus ; chemistry ; Immunohistochemistry ; Rats ; Rats, Wistar ; Stress, Psychological ; metabolism ; psychology ; Sucrose ; administration & dosage

OBJECTIVETo evaluate the effects of glial cell line-derived neurotrophic factor (GDNF) and memantine on the long-term prognosis in neonatal rats with ischemia-induced periventricular leukomalacia (PVL).

METHODSThirty-two 5-day-old neonatal rats were randomly divided into 4 groups: sham-operated, PVL, GDNF-treated and memantine-treated. PVL was induced by right carotid artery ligation and hypoxia in the PVL, GDNF-treated and memantine-treated groups. GDNF (100 μg/kg) or memantine (20 mg/kg) was injected in the two treatment groups immediately after PVL inducement. The weight of the rats was measured immediately before and after hypoxia ischemia (HI). Both of Morris water maze test and Rivlin inclined plane test were performed at 26 days old (21 days after HI). The values of the escape latency (EL) and swimming distance, and the maximum inclined plane degree which the rats could stand at least 5 seconds were compared among the four groups.

RESULTSThe lower weight, the prolonged mean values of EL and swimming distance and the reduced maximum inclined plane degree were observed in the PVL group compared to those in the sham-operated, GDNF-treated and memantine-treated groups. There were no significant differences in the weight, the values of EI and swimming distance and the maximum inclined plane degree between the two treatment groups and the sham-operated group.

CONCLUSIONSThe administration of either GDNF or memantine can markedly increase the abilities of spatial discrimination,learning and memory, and motor coordination, promote weight gain, and improve long-term prognosis in rats with PVL.

Animals ; Animals, Newborn ; Body Weight ; Excitatory Amino Acid Antagonists ; therapeutic use ; Glial Cell Line-Derived Neurotrophic Factor ; therapeutic use ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; drug therapy ; psychology ; Maze Learning ; drug effects ; Memantine ; therapeutic use ; Motor Activity ; drug effects ; Rats

OBJECTIVETo investigate whether the effect of N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) on transforming growth factor beta (TGF-beta1) and connective tissues growth factor (CTGF) was involved in AcSDKP's antifibrotic effect on the rats with silicosis.

METHODSRats were divided into 6 groups randomly, 10 rats in each group: Control of silicotic model: 1.0 ml normal sodium and was killed after 4 or 8 weeks; Silicotic model 1: 50 mg/ml silica suspension and was killed after 4 weeks; Silicotic model 2: 50 mg/ml silica suspension and was killed after 8 weeks; Anti-fibrosis treatment of AcSDKP: after each rat was intratracheally instilled with 50 mg/ml silica suspension for 4 weeks, AcSDKP 800 microg/(kg x d) was administered into every rat and rats were killed at the 8 weeks; Preventing fibrosis treatment of AcSDKP: after AcSDKP [800 microg/(kg x d)] was administered into every rat for 48 hours, each rat was intratracheally instilled with 50 mg/ml silica suspension and rats were killed at the 8 weeks. Lung fibrosis in morphology was observed by HE staining. The expressions of TGF-beta1 and CTGF in lung were observed by immunohistochemistry. The mRNA expressions of TGF-beta1 and CTGF in lung were observed by real-time PCR.

RESULTSIn anti-fibrosis treatment of AcSDKP group, protein expression of TGF-beta1 and CTGF were (0.244 +/- 0.016) and (0.241 +/- 0.017) respectively, and significantly lower that those in the silicotic model 1 and 2 groups; mRNA expressions of TGF-beta1 and CTGF decreased, mRNA expressions of CTGF were significantly lower that those in the silicotic model 1 and 2 groups (P < 0.05); In preventing fibrosis treatment of AcSDKP group, protein expression and mRNA expression of TGF-beta1 were significantly lower that those in the silicotic model 2 group (P < 0.05).

CONCLUSIONAcSDKP can decrease the expressions of TGF-beta1 and CTGF in lung tissues of the rats with experimentally induced pulmonary fibrosis.

Animals ; Connective Tissue Growth Factor ; metabolism ; Disease Models, Animal ; Lung ; drug effects ; metabolism ; Male ; Oligopeptides ; pharmacology ; Pulmonary Fibrosis ; metabolism ; Rats ; Rats, Sprague-Dawley ; Silicosis ; metabolism ; Transforming Growth Factor beta ; metabolism

OBJECTIVETo investigate the role of extracellular signal-regulated kinase 1/2 on the inhibition of N-acetyl-seryl-aspartyl-lysyl-proline (AcSDKP) on the proliferation and collagen synthesis of cultured rat pulmonary fibroblasts induced by platelet-derived growth factor (PDGF).

METHODSPulmonary fibroblasts were prepared from lungs of neonatal Wistar rats as described previously. Cells were divided into 4 groups: (1) control group (0.4% FBS group); (2) PDGF (10 ng/ml) stimulated group; (3) PD98059+PDGF group (25 micromol/L PD98059+10 ng/ml PDGF); (4) AcSDKP+PDGF group (10(-8) mol/L AcSDKP+10 ng/ml PDGF). All experiments were performed in the fourth passages. Metabolic activity of fibroblasts was observed by MTT, and expressions of type I and type III collagen were measured by immunocytochemistry and western blot. Expressions of phospho-ERK1/2 and ERK1/2 were detected by western blot.

RESULTSCompared with control group, exposure of pulmonary fibroblasts to 10 ng/ml PDGF increased cell metabolic activity, expression of type I and type III collagen and phosphorylation of ERK1/2. 25 micromol/L PD98059 and AcSDKP both could inhibit the metabolic activity of pulmonary fibroblasts, type I and type III collagen synthesis and phosphorylation of ERK1/ 2 induced by PDGF, with significant differences (P < 0.05). AcSDKP+PDGF group compared with PDGF stimulated group, metabolic activity of pulmonary fibroblasts decreased to 77.4%. Immunocytochemistry result showed that in AcSDKP+PDGF group, expressions of type I and type III collagen decreased to 69.3% and 67.2% compared with those of PDGF stimulated group. Western blot result showed that in AcSDKP+PDGF group, expressions of type I and type III collagen decreased to 92.4% and 78.0%, phospho-ERK1/2 decreased to 83.5% compared with those of PDGF stimulated group, with significant differences (P < 0.05).

CONCLUSIONERK1/2 plays an important role in the inhibition of AcSDKP on the proliferation and collagen synthesis of cultured rat pulmonary fibroblasts induced by PDGF.

Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Collagen ; biosynthesis ; Fibroblasts ; drug effects ; metabolism ; physiology ; MAP Kinase Signaling System ; physiology ; Oligopeptides ; pharmacology ; Platelet-Derived Growth Factor ; pharmacology ; Rats ; Rats, Wistar

OBJECTIVEThe reporting of patient-reported outcomes (PRO) instrument development is vital for both researchers and clinicians to determine its validity, thus, we propose the Preferred Reporting Items for PRO Instrument Development (PRIPROID) to improve the quality of reports.

METHODSAbiding by the guidance published by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, we had performed 6 steps for items development: identified the need for a guideline, performed a literature review, obtained funding for the guideline initiative, identified participants, conducted a Delphi exercise and generated a list of PRIPROID items for consideration at the face-to-face meeting.

RESULTSTwenty three items subheadings under 7 topics were included: title and structured abstract, rationale, objectives, intention, eligibility criteria, conceptual framework, items generation, response options, scoring, times, administrative modes, burden assessment, properties assessment, statistical methods, participants, main results, and additional analysis, summary of evidence, limitations, clinical attentions, and conclusions, item pools or final form, and funding.

CONCLUSIONSThe PRIPROID contains many elements of the PRO research, and this assists researchers to report their results more accurately and to a certain degree use this instrument to evaluate the quality of the research methods.

Humans ; Outcome Assessment (Health Care) ; Practice Guidelines as Topic ; Research Report ; Research Support as Topic ; Treatment Outcome