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.

Objective To investigate whether unfolded protein response (UPR) plays a role in the pathogenesis of spondyloarthritis (SpA),and to assess UPR-related gene expression in SpA and other arthritis patients.Methods Eighteen patients with SpA,12 with rheumatoid arthritis (RA) and 6 with osteoarthritis (OA) were recruited.Macrophages were isolated from synovial fluid samples by immunomagnetic separation.The expression of UPR-regulated genes,including binding immunoglobulin protein (BiP),glucose-regulated protein 94 (GRP94),C/EBP homologous protein (CHOP),growth arrested and DNA damage-inducible 34 (GADD34),X-box binding protein 1 (XBP-1) and endoplasmic reticulum DnaJ homolog 4 (ERdj4),was tested by real time polymerase chain reaction (PCR).Results Compared with macrophages in OA patients,the expression of BiP and GRP94 mRNA [(6.06 ± 2.08) × 10-2 vs (1.11 ±0.72) × 10-2 for BiP mRNA,11.80(7.30-38.40) × 10-3 vs 1.27(1.02-4.18) × 10-3 for GRP94 mRNA,both P values ＜0.01] was significantly increased in macrophages in SpA patients.XBP1 mRNA was up-regulated [(12.70 ± 5.20) × 10-3 vs (4.14 ± 2.56) × 10-3,p ＜ 0.01] in SpA group as well.UPR-regulated gene expression in SpA patients with HLA-B27 positive or HLA-B27 negative was similar.However,none of UPR-regulated genes showed different expression between the SpA group and RA group except for GADD34 mRNA [7.30 (5.56-15.40) × 10-3 vs 21.30 (12.20-27.60) × 10-3,P =0.009].Conclusions Our data suggest that UPR possibly participates in the pathogenesis of SpA,although the relationship between HLA-B27 and UPR still needs further investigation.

Objective To evaluate the performance of an improved skin prick test in the screening for allergens.Methods A total of 475 patients with chronic urticaria who aged from 3 to 81 years were enrolled in this study,and classified into the control group (n =235) and research group (n =240).Traditional and improved skin prick test were conducted in the control and research group respectively.The allergen detection rate was compared between the two test methods.Results The allergen detection rate was 65.4％ and 67.2％ respectively for the improved and traditional skin prick test,respectively (P ＞ 0.05).House dust mites were the most common sensitizing agent.Conclusion The improved skin prick test can offer reliable evidence for chnical diagnosis with a relatively convenient and safe procedure.

Adult ; Congresses as Topic ; Hearing ; Hearing Tests ; Humans ; Mass Screening

Aged ; Female ; Hearing Loss, Bilateral ; diagnosis ; etiology ; Humans ; Osteitis Deformans ; complications ; diagnosis

Objective To evaluate the clinical results of a procedure for treatment of avulsion fracture of posterior cruciate ligament (PCL) using arthroscopic reduction and Orthocord suture.Methods The clinical data of 13 patients who underwent arthroscopic reduction and Orthocord suture fixation for PCL avulsion fracture of the tibial eminence from October 2009 to June 2010 was analyzed retrospectively.Follow-up assessment including Lysholm knee score,and radiographic evaluation.Results All 13 patients achieved follow-up with 10-14 ( 12 ± 2) months.No significant complications were noted,such as swelling,pain or disability of knee.Drawing test was negative.The preoperative Lysholm score in the 13 knees was (72.3 ±2.8) scores,the postoperative Lysholm score was (93.2 ± 1.8) scores,difference was statistically significant (t =15.8,P＜ 0.05 ).Conclusions Treating PCL avulsion fracture with arthroscopic fixation by use of Orthocord suture can restore ligament length,stabilize fragments,promote early motion.

Herpesviruses is one of the most common human infectious diseases, which can be divided into different types based on clinical infection degree.Herpes simplex virus usually results in buccal and genital mucocutaneous infections, while cytomegalovirus is the most common opportunistic pathogen associated with significant morbidity and mortality in immunocompromised hosts, especially in transplant and cancer patients.Although nucleoside analogues are effective antiviral drugs, the emergence of drug-resistant viruses has created a barrier for the treatment of herpesviruses infections, especially in immunocompromised patients.Therefore, novel therapeutic agents are needed to avoid the limitations of drug resistance.In this article, research progress in the therapeutic agents for drug-resistant herpesviruses was reviewed from the aspects of non-nucleoside analogues, novel antiviral targets and newly antiviral mechanisms.

Objective: To clone the 5＇-flanking region of the human CD34 gene containing transcriptional regulatory sequence (TRS). Methods: According to the registered 5＇-flanking region of CD34 gene, two pairs of primers were designed and net-PCR was used to amplify 661 bp long TRS of CD34 gene. The CD34 TRS fragment was cloned into reported plasmid pEGFP-1. The role of the regulating the specific expression of recombinant plasmid pCD34 EGFP in hematopoietic and non-hematopoietic cells was observed. Results: Restrictive endonuclease identification and DNA sequencing provedthat the CD34 promoter cloned was consistent with the sequence reported to a large extent. It could induce the EGFP gene to express in hematopoietic cell line K562 specifically, while has no effect on hepatocellular carcinoma cell HepG-2. Conclusion: The cloned CD34 gene TRS has the effect of regulating gene expression specifically. The study established the fundament for the construction of specific gene expression vector used in hematopoietic system cells.

Objective To observe the preventive and therapeutic effects of L-carnitine on the metabolic disorder and cardiac remodeling in alcoholic cardiomyopathy. Methods Experimental animals were divided into three groups: alcohol-fed group(A), an alcohol/L-carnitine fed group(B) and a control group(C). Free fatty acid(FFA) and earnitine were detected in the blood serum at different time. mRNA and protein expressions of peroxisome proliferator-activated receptors (PPARα and PPARγ), retinoic acid receptor retinoid X receptor alpha (RXRα), earnitine palmitoyl transferase isoform and medium-chain acyl-CoA dehydrogenase (MCAD) were observed with RT-PCR and Western blotting methods. Results (1) When group A and B were compared with group C, FFA was increased and carnitine was decreased;mRNA and protein expressions of PPARα, RXRα, CPT-Ⅰ and MCAD were decreased with the development of alcoholic cardiomyopathy (ACM), being more significantly in group A than group B (P < 0.05). (2) mRNA and protein expressions of PPARγ had no statistical significance between these three groups at the end of 2 and 4 months(P>0.05), but after 6 months, they were increased in group B and decreased in group A (A vs. C,P<0.01;B vs. C,P<0.05). Conclusion Metabolic disorder and cardiac remodeling occur in the development process of ACM; they are partly prevented by L-carnitine through downregulating mRNA and protein expressions of PPARct, RXRα, CPT-Ⅰ, MCAD and PPARγ.

Objective To study to the effect of 1064-nm Q-switched Nd:YAG laser irradiation on the melanogenesis in a human epidermal melanocyte line PIG. Methods Cultured PIG cells were irradiated with 1064-nm Q-switched Nd:YAG laser (Medlite C6) at different energy densities for 10 times. After additional culture for various durations, cell viability was detected by MT assay, tyrosinase activity by dopa oxidation assay, mRNA and protein expressions of tyrosinase, tyrosinase related protein (TRP)-1 and TRP-2 by real-time quantitative fluorescent RT-PCR and Westen blotting respectively, Results The irradiation with Q-switched Nd:YAG laser at energy densities from 1 to 3 J/cm2 had no obvious effect on the viability of PIG cells. After irradiation with Nd:YAG laser at 1 J/cm2, PIG cells showed a significant increase in the tyrosinase activity,mRNA expressions of tyrosinase and TRP-1 compared with unirradiated cells (0.563 ± 0.014 vs 0.501 ±0.019, 1.40±0.11 vs 1.0, 1.28 ± 0.03 vs 1.0, all P＜ 0.05), but both the mRNA (0.91 ± 0.17 vs 1.0, P＞0.05) and protein expressions of TRP-2 experienced no significant changes before and after the irradiation.However, a significant decrease was noted in PIG cells irradiated with Nd:YAG laser at 3 J/cm2 in tyrosinase activity, mRNA and protein expressions of tyrosinase (0.70 ± 0.02 vs 1.0, 0.64 ± 0.05 vs 1.0, both P ＜ 0.05),TRP-1 (0.73±0.04 vs l.0, 0.86±0.17 vs l.0, both P＜0.05) andTRP-2 (0.68±0.04 vs l.0,0.69±0.11vs 1.0, both P ＜0.05) in comparison with unirradiated PIG cells. Conclusions The 1064-nm Q-switched Nd:YAG laser irradiation may affect the melanogenesis in PIG cells. With no influence on cell viability, the 1064-nm Q-switched Nd:YAG laser at 1 J/cm2 could enhance melanogenesis, while that at 3 J/cm2 could suppress melanogenesis, in PIG cells.