Objective To compare the differences in the average transaction costs per-referral patients under different models of Integrated Delivery Systems(IDS).Methods Using a typical case sampling method,it selected referred patients from three IDS models:the county medical alliance in D City(Qinghai Province),the urban medical consortium in J District(Zhengzhou City,Henan Province),and the health management coalition in N County(Shandong Province).Structured questionnaires collected demographics,average transaction costs per-referral and cost perceptions.t-tests and ANOVA assessed cost differences;generalized linear regression identified influencing factors.Results Among 915 patients,the average transaction costs per-referral were 1 035.05 yuan(county alliance),195.31 yuan(urban consortium),and 700.97 yuan(health management coalition),with statistically significant differences(P＜0.05).The urban consortium exhibited lower time costs and specialized input costs.Key influencing factors included older age(county alliance),education level,employment status,and referral travel time(urban consortium),as well as urban-rural disparities(health management coalition).Patients'cost perceptions significantly differed across models(P＜0.05).Conclusion The urban medical consortium demonstrated the lowest patient the average transaction costs,highlighting its institutional advantage in minimizing financial burdens.

Objective To compare the differences in the average transaction costs per-referral patients under different models of Integrated Delivery Systems(IDS).Methods Using a typical case sampling method,it selected referred patients from three IDS models:the county medical alliance in D City(Qinghai Province),the urban medical consortium in J District(Zhengzhou City,Henan Province),and the health management coalition in N County(Shandong Province).Structured questionnaires collected demographics,average transaction costs per-referral and cost perceptions.t-tests and ANOVA assessed cost differences;generalized linear regression identified influencing factors.Results Among 915 patients,the average transaction costs per-referral were 1 035.05 yuan(county alliance),195.31 yuan(urban consortium),and 700.97 yuan(health management coalition),with statistically significant differences(P＜0.05).The urban consortium exhibited lower time costs and specialized input costs.Key influencing factors included older age(county alliance),education level,employment status,and referral travel time(urban consortium),as well as urban-rural disparities(health management coalition).Patients'cost perceptions significantly differed across models(P＜0.05).Conclusion The urban medical consortium demonstrated the lowest patient the average transaction costs,highlighting its institutional advantage in minimizing financial burdens.

Central nervous system idiopathic inflammatory demyelinating diseases (CNS-IIDD) is an autoimmune disorder characterized by inflammatory demyelination. The disease follows a course of recurrent attacks and remission, with some cases displaying continuous progression, often resulting in disability. The incidence of CNS-IIDD has been increasing, imposing a substantial burden on both patients′ families and society in recent years. A promising strategy for disease management involves the identification of humoral biomarkers to diagnose CNS-IIDD and predict disease attack and progression. Such biomarkers could aid in identifying individuals at high risk of disability, enabling targeted preventive interventions. This study summarizes advancements in the identification of humoral biomarkers and their potential for predicting disease activity and progression to offer novel insights into the management of CNS-IIDD.

Central nervous system idiopathic inflammatory demyelinating diseases (CNS-IIDD) is an autoimmune disorder characterized by inflammatory demyelination. The disease follows a course of recurrent attacks and remission, with some cases displaying continuous progression, often resulting in disability. The incidence of CNS-IIDD has been increasing, imposing a substantial burden on both patients′ families and society in recent years. A promising strategy for disease management involves the identification of humoral biomarkers to diagnose CNS-IIDD and predict disease attack and progression. Such biomarkers could aid in identifying individuals at high risk of disability, enabling targeted preventive interventions. This study summarizes advancements in the identification of humoral biomarkers and their potential for predicting disease activity and progression to offer novel insights into the management of CNS-IIDD.

Objective:To explore the effect of preoperative visit with Child Life mode in the management of preschool children′s anxiety.Methods:A total of 80 cases of children of pre-school age who were operated from September 2018 to February 2019 were selected by cluster sampling method. The children from September to November 2018 who were given the traditional mode of preoperative visit were set as the control group. Children from December 2018 to February 2019 who were given preoperative visit with Child Life mode were set as the experimental group. The Modified Yale Perioperative Anxiety Scale (m-YPAS) scores, Induction Compliance Checklist (ICC) scores and Pediatric Anesthesia Emergence Delirium (PAED) scores were compared between the two groups at 4 different perioperative time points (6 hours after admission, waiting for surgery, induction of anesthesia, and 6 hours after surgery).Results:Totally three patients were suspended from the study due to surgery. A total of 77 children were studied, 38 in the experimental group and 39 in the control group. The score of m-YPAS in the experimental group was significantly lower than that of the control group(17.57±16.64 vs. 42.04±27.46, t value was 3.85, P<0.01) while waiting for surgery. The score of m-YPAS in the experimental group was significantly lower than control group (31.64±27.95 vs. 62.22±25.13, t value was 4.26, P<0.01) at the anesthesia induction. Compare with the control group, the score of m-YPAS in the experimental group showed no significant difference at both time of 6 hours after admission (18.19±17.83 vs.19.85±17.92, t value was 0.87, P>0.05) and 6 hours after surgery(35.61±15.70 vs. 41.81±17.97, t value was 1.37, P>0.05). Compare with the control group the score of ICC in the experimental group was significantly decreased (1.40±1.39 vs. 3.78±2.60, t value was 4.88, P<0.01) at the anesthesia induction. The score of PEAD in the experimental group and control group, there was no significant difference between the two groups (7.18±2.45 vs. 7.85±3.05, t value was 0.91, P>0.05). Conclusions:Compared with the traditional preoperative visit mode, the preoperative visit mode of Child Life can effectively relieve the anxiety of preschool children undergoing general anesthesia surgery while they are waiting for surgery and during anesthesia induction, and can improve the degree of cooperation during anesthesia induction.

OBJECTIVE: To explore the effect of occupational lead exposure on the relative telomere length(RTL) and mRNA expression of telomere-binding protein POT1-interacting protein 1(TPP1) in peripheral blood of workers. METHODS: A total of 303 workers exposed to lead were selected as the exposure group and 72 administrative logisticians personnel in the same factory as the control group using the simple random sampling method. Their peripheral blood samples were collected and were used to detect the blood lead level by Graphite furnace atomic absorption spectrometry. RTL and the relative expression of TPP1 mRNA by real-time quantitative polymerase chain reaction. RESULTS: The blood lead level of the exposure group was higher [Media(M): 68.2 vs 266.1 μg/L, P<0.01], the RTL was shorter(M: 0.96 vs 0.70, P<0.01), and the relative mRNA expression of TPP1 was lower(M: 0.92 vs 0.51, P<0.01) compared with the control group. Spearman correlation analysis results showed that the blood lead level were both negatively correlated with RTL [Spearman correlation coefficient(r_S) =-0.18, P<0.01], and the relative mRNA expression of TPP1(r_S=-0.19, P<0.01), while the RTL was positively correlated with the risk of RTL shortening and the relative mRNA expression of TPP1 decline was increased in lead exposure(P<0.01). CONCLUSION: Lead exposure can shorten the RTL and reduce the relative mRNA expression of TPP1 in workers. The mechanism may be that lead interferes with telomere repair process by inhibiting the mRNA expression of TPP1.

Objective To explore the relationship between responsibility and social adaptation of the left-behind middle school students and to provide evidence for mental health education of left-behind children.Methods 290 left-behind middle school students were selected by cluster-random-sampling.All of them were assessed by the middle school students' social adaptability scale (SAS-SSS),the inventory of parent and peer attachment (IPPA) and the scale of high school students' responsibility.Results The correlation between responsibility,attachment behavior and social adaptation of left-behind middle school students were significant(r=0.39,r=0.56,P＜0.01).There were significant differences between gender on the responsibility(male(202.64±26.78) vs female(212.67±23.24)).Regression analysis showed that mother attachment,overall responsibility,general responsibility and special fault responsibility could predict the social adaptation(P＜0.05).Responsibility and its factors played a mediating role between attachment and adaptation,taking 52.1％,20.1％,30.8％,9.1％,47.9％,40.7％ proportion of the total effect.Conclusion Responsibility is an important factor affecting the social adaptation of left-behind middle school students.

Objective To investigate the effect of hepatopoietin Cn(HPPCn) on liver stem cells.Methods In this study, WB-F344 cell line was used, and MTT and flow cytometry assay were conducted to determine cell proliferation and apoptosis.Transwell assay was used to test the migration of WB-F344 cells.A 2AAF-partial hepatectomy(PH) mouse model was used to observe the effect of HPPCn on liver stem cell proliferation in vivo.Results HPPCn enhanced WB-F344 cell proliferation and migration and activated the SphK1, Erk and Stat3 signal pathways.The analysis of the 2AAF-PH mouse model showed that oval cells in the experimental group far outnumbered those in control and the regeneration of the liver was improved post PH.Conclusion HPPCn can increase the liver stem cell proliferation and survival while promoting the regenenation of the liver by augmenting oval cell proliferation.

The stable isotope labeling by amino acids in culture (SILAC) based quantitative proteomics serves as a gold standard because of the high accuracy and throughput for protein identifications and quantification. In this study, we discussed the application of SILAC technology in mammal model, and developed quantitative internal standard for comparative proteomics of disease model. The C57BL/6J mice fed by special diet containing the 13C6-Lysine and bred F2 generation. We identified and analyzed total proteins of 9 mice tissues of F2 generation, including brain, lung, heart, stomach, intestine, liver, spleen, kidney, and muscle. Quantitative analysis information could evaluate the mice and different tissues' labeling efficiency. Liver was the most efficient, brain the least, and the labeling efficiency were 96.34%±0.90% and 92.62%±1.98% respectively. The average of the labeling efficiency of F2 generation was 95.80%±0.64%, which met the international standard (≥ 95%) for SILAC quantitative proteomics effective study. SILAC technology was successfully extended to mammalian model system, which will provide powerful tools for the mechanism study of the pathophysiology process with mouse model.
Amino Acids ; chemistry ; Animals ; Diet ; veterinary ; Isotope Labeling ; Lysine ; chemistry ; Mice ; Mice, Inbred C57BL ; Proteins ; chemistry ; Proteomics ; methods

Objective To investigate the effect of HIF-2a silencing by transfection of siRNA into MG-63 cells un-der hypoxia. Methods HIF-2αexpression level in MG-63 cells under hypoxia was determined by Western Blot. Small in-terfering RNA (siRNA) was used to construct MG-63/siHIF-2α(siHIF-2α)cells and control MG-63/scramble (NC) cells. The expression levels of HIF-2α, Vascular endothelial growth factor (VEGF), p-Erk/ErK and Mcl-1 in MG-63, NC and si-HIF-2αcells was determined by Western Blot. NC and siHIF-2αcells were cultured under hypoxia. Cell viability was as-sessed by MTT assay. Migration was identified by scratch migration assay. Tumor formation was identified by clone formation assay. Nude mouse subcutaneous xenograft model was used to investigate tumor development in vivo. Results Hypoxia im-proved HIF-2αexpression in MG-63 cells in a time-dependent manner (F=2 037.412,P<0.001). HIF-2αexpression un-der hypoxia in siHIF-2αcells was lower than that in NC cells (P<0.01). Cell viability of siHIF-2αcells under hypoxia for 12 h and 24 h were lower than that in NC cells (P<0.05 or P<0.01). The relative width of scratch in siHIF-2αgroup under hypoxia for 12 h and 24 h were larger than that in NC group (P<0.01 or P<0.01). When cell counts reach 1 000-5 000, the clone formation rates of siHIF-2αcells were lower than that in NC cells (P<0.05 or P<0.01). The expression of VEGF, p-Erk/Erk and Mcl-1 protein under hypoxia in siHIF-2αcells was lower than that in NC cells(P<0.01). Tumor sizes, weights and density of siHIF-2α group in nude mice were suppressed compared with those in NC group (P<0.01). Conclusion Blocking HIF-2αsignal pathway warrants its investigation as a potential strategy in osteosarcoma treatment.