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.

Objective: To identify the spatio-temporal clustering analysis of mumps in Wenzhou City, Zhejiang Province from 2010 to 2023, so as to provide the basis for improving mumps prevention and control strategies. Methods: Data of mumps cases in Wenzhou City from 2010 to 2023 were collected from the Monitoring and Reporting Management System of Chinese Disease Prevention and Control Information System. The spatio-temporal clustering characteristics of mumps incidence were identified using spatial autocorrelation analysis and spatio-temporal scan analysis. Results: A total of 20 455 mumps cases were reported in Wenzhou City from 2010 to 2023, with an average annual incidence of 17.54/105. There were 12 919 male and 7 536 female cases, with a male-to-female ratio of 1.71∶1. The children aged 5-<10 years had the highest incidence of mumps at 135.29/105. The incidence of mumps showed a downward trend from 46.82/105 in 2010 to 3.59/105 in 2023 (P<0.05). The incidence of mumps peaked from May to July and from November to January during 2010 and 2012, the winter peak became less evident after 2013, and no seasonal trends were observed after 2020. Spatial autocorrelation analysis showed there was a positive spatial correlation of mumps of other years, with the exception of 2018 (all Moran's I >0, all P<0.05). Lucheng District, Longwan District, Ouhai District, Cangnan County and Rui'an City were high-high clustering sites. Spatio-temporal scan analysis showed that the primary clustering area was centered in Nanbaixiang Street, Ouhai District, covering 50 towns (streets), with the clustering time from April 2010 to August 2013; the secondary clustering area was centered in Zaoxi Town, Cangnan County, covering 24 towns (streets), with the clustering time from January 2010 to June 2013. Conclusions The incidence of mumps in Wenzhou City from 2010 to 2023 showed a downward trend. The urban areas, Cangnan County and Rui'an City were the clustering areas.

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

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

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 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.

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.

OBJECTIVETo explore the effect of Shenxiong Huayu Capsule (SHC) on the cerebral ischemia-reperfusion (IR) injury and the expression of growth associated protein 43 (GAP43) after total cerebral IR in the hippocampal CA1 region of rats.

METHODSTotally 100 male adult SD rats were randomly divided into five groups, i.e., the control group, the model group, the group A (by taking SHC once daily), the group B (by taking SHC twice daily), and the group C (by taking SHC thrice daily), 20 in each group. The total IR model was prepared by improved Pulsinelli's 4-vessel occlusion method. Morphological changes of the hippocampal CA1 region were observed by HE staining at day 1, 3, 7, and 14. The expression of GAP43 in the hippocampal CA1 region was detected using immunohistochemical assay at day 1, 3, 7, and 14. Meanwhile, the behavioral score was determined. The expression of GAP43 in the hippocampal CA1 region was detected using Western blot at day 14.

RESULTSCompared with the control group, the expression of GAP43 increased in the model group, the behavioral score was elevated, degenerated neurons increased, and survival neurons decreased in the model group (all P < 0.05). Compared with the model group, the expression of GAP-43 increased (with the most significant difference seen in the group C, P < 0.01), the behavioral score significantly decreased, degenerated neurons decreased, and survival neurons increased in each HSC group (all P < 0.05). Survival neurons obviously increased at day 14, of which, most number of survival neurons and highest contents of GAP43 protein could be seen in the group C, showing statistical difference when compared with those of the group A and the group B (P < 0.01).

CONCLUSIONSHC had protective effect on total cerebral IR in the hippocampal CA1, which might be associated with increased expression of GAP43.

Animals ; Brain Ischemia ; metabolism ; CA1 Region, Hippocampal ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; GAP-43 Protein ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism