Objective:It aims to systematically evaluate the current status of knowledge,attitude,and practice(KAP)regarding universal commercial medical insurance among residents of the sample province from the demand-side perspective.Methods:Utilizing a quota sampling method,face-to-face surveys were conducted via the Questionnaire Star platform to collect demographic characteristics and KAP data of the participants.Comparisons of differences among different groups were made using t-tests,analysis of variance,and chi-square tests.Furthermore,multiple linear regression and structural equation modeling were utilized to analyze the influencing factors of KAP,as well as the pathways among these three factors.Results:Out of the 415 valid questionnaires collected,there were notable differences in KAP among respondents with diverse demographic backgrounds.Regression analysis revealed that education level,frequency of health check-ups,and engagement in other commercial health insurances significantly influenced knowledge;education level,involvement in other commercial health insurances,and self-assessed health status were pivotal in shaping attitudes;whereas age,education level,frequency of health check-ups,and participation in other commercial health insurances were critical in affecting practice.The path analysis results indicate that knowledge of universal commercial medical insurance has a significant direct association with attitude(β=0.379,P＜0.001)and practice(β=0.323,P＜0.001).It also influences practice through attitude as a mediator(β=0.016,P＜0.001),but the direct effect of attitude on practice is not significant(β=0.04,P=0.403).Conclusion:While residents in the sample province exhibit a positive attitude towards universal commercial medical insurance,there is a need to enhance their level of knowledge and engagement in practice.It is recommended to strengthen targeted educational and promotional measures to promote the healthy and sustainable development of universal insurance.

Objective:It aims to systematically evaluate the current status of knowledge,attitude,and practice(KAP)regarding universal commercial medical insurance among residents of the sample province from the demand-side perspective.Methods:Utilizing a quota sampling method,face-to-face surveys were conducted via the Questionnaire Star platform to collect demographic characteristics and KAP data of the participants.Comparisons of differences among different groups were made using t-tests,analysis of variance,and chi-square tests.Furthermore,multiple linear regression and structural equation modeling were utilized to analyze the influencing factors of KAP,as well as the pathways among these three factors.Results:Out of the 415 valid questionnaires collected,there were notable differences in KAP among respondents with diverse demographic backgrounds.Regression analysis revealed that education level,frequency of health check-ups,and engagement in other commercial health insurances significantly influenced knowledge;education level,involvement in other commercial health insurances,and self-assessed health status were pivotal in shaping attitudes;whereas age,education level,frequency of health check-ups,and participation in other commercial health insurances were critical in affecting practice.The path analysis results indicate that knowledge of universal commercial medical insurance has a significant direct association with attitude(β=0.379,P＜0.001)and practice(β=0.323,P＜0.001).It also influences practice through attitude as a mediator(β=0.016,P＜0.001),but the direct effect of attitude on practice is not significant(β=0.04,P=0.403).Conclusion:While residents in the sample province exhibit a positive attitude towards universal commercial medical insurance,there is a need to enhance their level of knowledge and engagement in practice.It is recommended to strengthen targeted educational and promotional measures to promote the healthy and sustainable development of universal insurance.

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

Objective To evaluate the prognostic significance of extent of resection (EOR) in patients with gradeⅢglioma, and the MRI sequence best related with tumor volume. Methods Ninety-six cases were studied retrospectively who were diagnosed as glioma of grade Ⅲ gliomas at Dalian Medical University Affiliated Hospital of Dalian Municipal Central Hospital during the period from 2010 to 2015. EOR was calculated using preoperative and postoperative contrast-enhanced T1-weighted and T2-weightedfluid attenuated inversion recovery (T2Flair) MR images. Univariate and multivariate analyses were performed to evaluate the correlation between EOR and overall survival (OS). Results The results of univariate analysis showed that patients with age<50 years(P=0.032), preoperative KPS>80 scores (P<0.01), no edema (P=0.005), postoperative chemotherapy (P<0.01) and T2Flair EOR≥68% (P<0.01) had better prognosis. Cox multivariate regression analysis showed that age(P=0.008), edema (P＝0.003), postoperative chemotherapy(P=0.000) and T2Flair EOR (P=0.004) were independent factors of prognosis for grade Ⅲ glioma patients. Conclusions T2Flair-EOR is one of the most significant prognostic predictors in patients with grade Ⅲ gliomas. An important survival advantage is associated with T2Flair-EOR≥68% for patients with gradeⅢgliomas.

OBJECTIVETo evaluate the effect of techniques of precise liver surgery for donor hepatectomy in living donor liver transplantation.

METHODSEighty-nine donors aged from 19 to 57 years were performed by the same surgical team from June 2006 to December 2013 in Chinese People's Liberation Army General Hospital.Individualized surgical program were developed according to preoperative imaging examination and hepatic functional reserve examination. The evaluation included liver function, liver volume, vascular anatomy and bile duct anatomy. According to the results after the operation, preoperative evaluation accuracy, postoperative donor liver function and postoperative complications were analyzed. ANOVA analysis was used to compare the difference of graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight. Pearson correlation test and linear regression analysis were used to verify the correlation between the estimated graft volume each method and actual graft postoperative weight.

RESULTSAll the 89 cases operation protocol as following, there were 5 cases with left lateral lobe graft, 10 cases with left lobe liver graft, 74 cases with right lobe graft. There were 59 cases with middle hepatic vein (MHV) harvested, and 30 cases without MHV. The mean graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight were (656.2±134.1) ml, (631.7±143.2) ml and (614.5±137.7) ml respectively. ANOVA analysis results showed that there were no statistically significant difference in the three methods (P>0.05). Compared to the actual postoperative graft weight, the average error rate of the two methods were 7.9% and 5.3% respectively. Pearson correlation test showed the graft volume calculated by two-dimensional and three-dimensional methods had a significantly positive correlation with actual graft weight (r=0.821, 0.890, P<0.01) and linear regression analyze showed the R2 were 0.674 and 0.792, respectively. The accuracy rate of preoperative evaluation about portal vein, hepatic vein, hepatic artery and bile duct were 100%, 100%, 97.8% and 95.5%, respectively. The preoperative plan and postoperative practical scheme coincidence rate was 95.5%. Overall donor complication rate was 7.4%. All donors were alive. Sixteen donors received right lobe hepatectomy with gallbladder preserved had a good liver function and gallbladder function.

CONCLUSIONThrough the precise preoperative evaluation, surgical planning, fine operation and excellent postoperative management, precise liver surgery technique can ensure the safety of donor in living donor liver transplantation.

Adult ; Bile Ducts ; Body Weight ; Hepatectomy ; methods ; Hepatic Artery ; Hepatic Veins ; Humans ; Linear Models ; Liver Transplantation ; methods ; Living Donors ; Middle Aged ; Portal Vein ; Postoperative Complications ; Postoperative Period ; Young Adult

BACKGROUND:The physical properties and chemical composition of teeth are very similar with human bone tissue, and there are a larger proportion of inorganic components. Therefore, tooth can be considered as a potential repair material for autologous or alogeneic bone defects. OBJECTIVE:To prepare polyetheretherketone/odontogenic biphasic bioceramic composite, and to test its mechanical properties. METHODS: The humanin vitro teeth of clinical waste were colected. The organic components were removed after a preliminary calcination. Another calcination was conducted after soaking in diammonium phosphate solution for 24 hours to prepare the biphasic ceramics with the main components of hydroxyapatite and β-tricalcium phosphate. The biphasic ceramics were ground and sieved using 200-mesh sieve folowed by impregnation in organic foam to prepare polyetheretherketone/odontogenic biphasic bioceramics. Phase analysis, scanning electron microscopy, elemental analysis, porosity, compressive strength and bond strength test were conducted. RESULTS AND CONCLUSION:Polyetheretherketone/odontogenic biphasic bioceramics presented porous network structure and interconnected holes, with the aperture of 100-800 μm, porosity of 73.65%, compressive strength of (165.260±11.703) N, bond strength of (14.63±6.21) MPa. P element content accounted for 19.8%, and Ca element content accounted for 40.5%. The main phases were β- tricalcium phosphate and hydroxyapatite. These results demonstrate that polyetheretherketone/odontogenic biphasic bioceramics have good mechanical properties.

Objective To determine the expression of G-protein coupled receptor 34 (GPR34) in hepatocellular carcinoma tissues.Methods Immunohistochemistry and tissue-array were used to determine GPR34 expression in human hepatocellular carcinoma tissues and matched adjacent tissues.A statistical analysis was performed to establish the potential correlation between GPR34 expression and the patients'clinicopathological characteristics,tumor progression,and prognosis.Results GPR34 is up-regulated in primary hepatocellular carcinoma tissues compared with matched adjacent tissues (P =0.003),and it was shown that GPR34 expression is significantly correlated with tumor size (P =0.024),small hepatocellular carcinoma(0.030) and infiltration(P =0.012),but not with sex,age,grade,chnical stage (all P ＞0.05) ; it was also shown that GPR34 expression had a significant influence on prognosis (X2 =5.617,P=0.018).Multivariate analyses showed that high GPR34 expression is an independent poor prognostic factor for overall survival (P =0.037).Conclusions The up-regulation of GPR34 acts as an potential prooncogene in the development and progression of hepatocellular carcinoma.GPR34 may be a useful diagnostic or prognostic molecular biomarker,and a potential target for therapeutic intervention.

Objective To optimize plan for right lobe living donor hepatectomy based on the territorial volume drained by the middle hepatic vein (MHV) as shown by preoperative MR image in donors.Methods Utilizing preoperative MR dynamic enhancement scanning image,virtually plot three types of hepatic parenchyma transsection plane based on the variation of including MHV for right lobe graft procurement. Results From June 2006 to May 2010,65 adult-to-adult right lobe living donor liver transplantations was performed at General Hospital of Chinese PLA,in which there were 43 grafts including MHV (66.2％,43/65 ), eight grafts including partial MHV which was dissected before the V4b abouchement ( 12.3％,8/65) and 14 grafts not including MHV (21.5％,14/65). There was no postoperative death in donors and the postoperative complications developed in 10.76％ (7/65). The recipients' perioperative mortality was 7.69％ (5/65). Ttwenty-one complications developed in 18 recipients,and the morbidity was 32.31％. The cumulative survival rates were 86％,77％ and 68％respectively for 1,2 and 3 years. Conclusions The optimizing liver resection plane could be practically designed preoperatively for right lobe graft procurement based on the territorial volume drained by MHV.

Objective: To establish a cell culture model of cervical-loop epithelial cells from Wistar rat lower incisors on culture bottle coated with rat tail collagen. Methods: The effect of self-made rat tail collagen on the culture of cervical-loop epithelial cells was observed. The cells were identified by immunohistochemistry staining. Results: Cervical-loop epithelial cells in Wistar rat lower incisors grew well in self-made rat tail collagen. The cervical-loop epithelial cells exhibited positive expression for integrin-β1 and monoclonal antibody CK in immunohistochemistry staining. Conclusion: The cell culture model of cervical-loop epithelial cells in Wistar rat lower incisors with self-made rat tail collagen can be helpful to research tooth development mechanism.

Objective To study the effect of thermo-radiotherapy on multidrug resistance (MDR) and levels of intracellular adriamycin (ADM) in tongue squamous cell carcinoma cell line Tca 8113 and its MDR cell line Tca 8113/CBDEA. Methods Samples of the two cell lines were treated with thermo-radiotherapy (42℃ for 0.5 h and 2 Gy of radiation). Four and 24 hours later, the expression of the MDR relative proteins P-glycoprotein (P-gp),multidrug resistance associate protein 1 (MRP1) and glutathione s-tranferase-π (GST-π) were detected using immu-nohistochemistry. Intracellular ADM concentrations were measured using an HTS 7000 Plus bioassay reader. Re-sults No change in the expression of P-gp was observed in the Tca 8113/CBDEA and Tca 8113 cell lines after 4 or 24 hours. Expression of MRP1 was not significantly altered in the Tca 8113/CBDEA cell line, but there was a signifi-cant drop in the Tca 8113 cell line 24 hours post-thermo-radiotherapy. Expression of GST-π was not altered in either the Tca 8113/CBDEA or the Tca 8113 cell line at 4 hours post-thermo-radiotherapy, but there was a significant de-crease at 24 hours. At both 4 and 24 hours, drug tolerance had decreased and intracellular drug concentration had in-creased significantly in both cell lines. Conclusions Thermo-radiotherapy can enhance the effects of chemotherapy and suppress the expression of MDR factors induced by radiation. The combination of hyperthermia and radiotherapy does not induce MDR.