Objective:To investigate the development trend of physical examination volume and revenue in health-checkup institutions in China from 2010 to 2019.Methods:In this longitudinal study, the annual income, annual physical examination volume and other indicators reflecting institutional size were collected with questionnaire from 374 health-checkup institutions in the year of 2010, 2015 and 2019. The geometric mean method is used to calculate the compound annual growth rate (CAGR) of the annual physical examination volume, annual income, mean per capita cost from 2010 to 2015 and 2015 to 2019.Results:The annual physical examination volume of health-checkup institutions increased from 1.81 (1.00, 3.20) ×10 4 person times in 2010 to 5.08(3.50, 7.28)×10 4 person times in 2019; the CAGR of the physical examination volume from 2010 to 2015 was 14.04%(8.14%, 23.78%), and it was 9.49%(3.39%, 19.07%) from 2015 to 2019. The annual revenue increased from 768.73 (350.00, 1 623.75) ×10 4 yuan in 2010 to 3 500.00 (1 997.73, 6 818.54) ×10 4 yuan in 2019; the CAGR of annual revenue from 2010 to 2015 was 25.75% (15.17%, 35.09%), and it was 15.67% (8.78%, 26.11%) from 2015 to 2019. The mean per capita cost increased from 434.26 (278.82, 666.66) yuan in 2010 to 755.80 (506.90, 1 005.42) yuan in 2019; the CAGR of the mean per capita cost was 9.82% (1.71%, 17.10%) from 2010 to 2015, and it was 5.37% (0.95%, 10.46%) from 2015 to 2019. Conclusion:From 2010 to 2019, health-checkup institutions in China developed rapidly, and the CAGR of the annual physical examination volume, annual revenue, mean per capita cost are high.

Objective To evaluate the relationship between silent information regulator 1 ( SIRT1)-extracellular-regulated kinase1∕2 ( ERK1∕2) pathway and chikusetsu saponin IVa-induced reduc-tion of isoflurane-elicited neurotoxicity in fetal rats in an in vitro experiment. Methods The hippocampal neurons isolated from rats at 16-18 days of gestation were primarily cultured for 7 days and divided into 3 groups ( n = 6 each) using a random number table method: control group ( Con group) , isoflurane group (Iso group) and chikusetsu saponin IVa plus isoflurane group (ChIV+Iso group). Hippocampal neurons were cultured routinely for 6 h in Con group. Hippocampal neurons were exposed to 1. 8％ isoflurane for 6 h in an incubator in Iso group. Chikusetsu saponin IVa 25μg∕ml was added to the culture medium, and hipp-ocampal neurons were incubated for 6 h and then exposed to 1. 8％ isoflurane for 6 h in an incubator in ChIV+Iso group. The supernatant was collected for determination of the amount of lactic dehydrogenase ( LDH) released, neuronal viability ( by CCK-8) and expression of SIRT1, ERK1∕2 and phosphorylated ERK1∕2 ( p-ERK1∕2) ( by Western blot) . Results Compared with Con group, the neuronal viability was significantly decreased, the amount of LDH released was increased, and the expression of SIRT1 and p-ERK1∕2 was down-regulated in Iso group ( P<0. 05) . Compared with Iso group, the neuronal viability was significantly increased, the amount of LDH released was decreased, and the expression of SIRT1 and p-ERK1∕2 was up-regulated in ChIV+Iso group ( P<0. 05) . Conclusion The mechanism by which chikuset-su saponin IVa reduces isoflurane-elicited neurotoxicity is related to activating SIRT1-ERK1∕2 pathway in fe-tal rats in an in vitro experiment.

Objective To investigate the radiographic classification and presentation of atypical spinal tuberculosis in adults.Methods Data of 45 consecutive patients who had suffered from atypical spinal tuberculosis confirmed by surgical interventions and pathologic examinations at our department from February 2000 to August 2012 were retrospectively analyzed.There were 29 males and 16 females,aged from 20 to 71 years (mean,46.2 years).Twenty-five patients presented with low-grade fever,lassitude and loss of weight,and the other 20 patients denied the constitutional symptoms of tuberculosis.An increased erythrocyte sedimentation rate (range,25-107 mm/1 h) was found in 37 patients.All patients were investigated by the following imaging resources:plain X-rays,CT scan and MRI.3D reconstruction CT was performed in 12 patients and PET-CT was performed in 2 patients.All patients were treated surgically and confirmed by pathologic examinations and 3 patients had undergone CT-guided biopsy.Results Atypical spinal tuberculosis presented in different radiographic presentation forms.Nine patients had involvement of a single vertebral body,which was depicted with nonuniformly increased signal intensity on T2-weighted MR images.CT scan showed irregular bony destruction in old patients and solitary osteolytic lesion with well-defined margins in young adults.There were 2 cases of isolated affection in the posterior elements (vertebral appendages type),and the involved vertebral appendages demonstrated hyperintense signal on T2-weighted MR images and bony destruction on CT scan.There were 8 cases of simultaneous affection in the anterior and posterior element of one vertebra (circumferential vertebral involvement type),and CT scan showed multiple bony destruction in vertebral body and neural arch.There were 5 cases of affection in disc (intervertebral disc involvement type),which presented decreased signal in MRI and protruding disc pressing the dural sac could be found.There were 14 cases of multiple vertebral tuberculosis in continuity (contiguous spinal tuberculosis),which presented multiple tuberculosis lesions on 3D-CT.There were 7 cases of multiple vertebral tuberculosis in noncontinuity (noncontiguous spinal tuberculosis),which presented destructive tubercular lesions affected different levels in different regions of the spine on MRI.Conclusion Atypical spinal tuberculosis had multiply radiographic presentation forms and atypical radiographic features.Worm-eaten destruction of bone or vertebral endplate,marrow edema and increased signal intensity of paraspinal ligament are features of radiographic presentation in diagnosis of atypical spinal tuberculosis.

Objective To investigate cerebrospinal fluid characteristics and clinical features in children with severe hand,foot and mouth disease (HFMD) induced by enterovirus 71 (EV71) infection.Methods A total of 114 children with severe HFMD,in whom EV71 was detected by reverse transcription polymerase chain reaction (RT-PCR),were admitted in Hangzhou Children's Hospital during May and August 2013.Seventy-eight children with severe HFMD induced by other enteroviruses admitted at the same period served as controls.The results of cerebrospinal fluids (CSF) routine examination and biochemical tests,and the clinical symptoms were compared between two groups.Differences in enumeration data were compared with x2 test,and measurement data were compared with Mann-Whitney U test.Results The incidences of vomiting and limb shaking in EV71 infection group were 35.1％ and 50.9％,which were higher than those in control group (x2 =7.864 and 19.682,P ＜ 0.05).The incidence of limb shaking in children with nucleated cells count ≥ 100 × 106/L in EV71 group was higher than that with nucleated cells count ＜ 100 × 106/L (72.3％ vs.35.8％,x2 =14.740,P =0.000).The nucleated cells count,protein quantity and their positive rates in EVT1 infected group were higher than those in control group (Z =-9.458 and-6.591,P=0.000; x2=105.421 and 10.932,P =0.000 and 0.001).Conclusion The symptoms of nervous system damage and abnormal CSF examination were more serious in HFMD induced by EV71 infection,and in EV71 infected patients the incidence of limb shaking is correlated with nucleated cell count in CSF.

ObjectiveTo explore the antitumor effect of solanine and its mechanisms.MethodsThe in vivo antitumor effect of solanine was observed using models developed through in vivo transplantation of tumor cells; In vitro lines of sensitive antitumor cells were selected from the digestive system using MTT assay; The effect of solanine on cell morphology was observed using transmission electronic microscopy; The morphology of apoptotic cells was observed using Annexin V/PI double staining and laser confocal scanning microscopy (LCSM); The rate of cell apoptosis was measured using Annexin V/PI double staining and flow cytometry; The concentration of intracellular Ca2+ ([Ca2+]1) was determined using Fluo-3/AM staining and LCSM; The membrane potential of cellular mitochondria was determined using TMRE staining and LCSM; The protein expression of Bcl-2 and Bax was measured using immunological marking and LCSM; And the activity of caspase-3 was measured using the colorimetric method.ResultsSolanine could inhibit the growth of tumor weight in S180 tumor-bearing mice and prolong the survival time of H22 tumor-bearing mice.MTT assay revealed that HepG2 cells were quite sensitive to solanine because solanine could induce morphological changes in HepG2 cells,with the rate of early apoptosis being 4％,8.5％,and 20.1％,for HepG2 cells treated for 24 h with solanine at concentration of 0.4,2,and 10 μg/mL,respectively.Solanine could raise the [Ca2+]i and lower the membrane potential.It could reduce the protein expression of Bcl-2 while increase that of Bax,thus increasing the activity of caspase-3.ConclusionThe obvious antitumor activity of sotanine in human hepatocarcinoma is demonstrated.This inhibitory effect is achieved through solanine decreasing the Bcl-2/Bax ratio,thus increasing [Ca2+]i,which could enhance the enzymatic activity of the caspase family,thus inducing the apoptosis of HepG2 cells.

OBJECTIVETo study how the way in which betaine promotes the proliferation of mouse spleen lymphocytes is related to calcium channels.

METHODBALB/c mice were used for this experiment. Mouse spleen lymphocytes were obtained through in vitro cultivation after they had been separated, and were divided into a negative control group, a Con A group, and 0.04, 0.4, 4, and 20 mmol x L(-1) betaine groups. MTT was used to observe the effect of betaine on the proliferation of mouse spleen lymphocytes; flow cytometry was used to measure the changes in the cell cycle of mouse spleen lymphocytes; and laser confocal scanning microscopy was used to observe the changes in the intracellular [Ca2+]i of mouse spleen lymphocytes after betaine or different calcium channel blockers were applied.

RESULTBetaine was found to promote the proliferation of mouse spleen lymphocytes 12 h after it had been applied in vitro in concentrations of 4 and 20 mmol x L(-1). It was also found to promote the proliferation of mouse spleen lymphocytes 24 h and 48 h after it had been applied in vitro in concentrations of 0.04, 0.4, 4, and 20 mmol x L(-1), with the effect being most marked for the 4 mmol x L(-1) group 24 h after its application. It was found to facilitate the entry of mouse spleen lymphocytes from the G0/G1 to the S phase 4, 6, 18, and 24 h after it had been applied to mouse spleen lymphocytes in a concentration of 4 mmol x L(-1), with the effect being most marked at 18 h after its application. Intracellular [Ca2+]i in mouse spleen lymphocytes increased significantly (P < 0.01) 6, 12, 18 h after 4 mmol x L(-1) betaine had acted on the lymphocytes, with the effect being most marked at 6 h. The calcium channel blockers nifidipine, diltiazem, mibefradil, and genistein had no effect on the increase of the intracellular [Ca2+]i in mouse spleen lymphocytes due to the application of betaine, while verapamil, mycifradin, heparin, and procaine could block such increase.

CONCLUSIONBetaine facilitates the entry of mouse spleen lymphocytes from the G0/G1 into the S phase by raising the intracellular [Ca2+]i in these cells, thus promoting their proliferation. Intracellular [Ca2+]i increases mainly in two ways: (1) By affecting the alpha1 subunit of the L-type voltage-gated calcium channel with mediation by G proteins and thus leading to an efflux of intracellular calcium: (2) By affecting the IP3R and RyR calcium channels of the intracellular calcium stores and thus leading to the release of intracellular calcium.

Animals ; Betaine ; pharmacology ; Calcium ; metabolism ; Calcium Channels ; metabolism ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Female ; Lymphocytes ; cytology ; drug effects ; metabolism ; Male ; Mice ; Mice, Inbred BALB C

BACKGROUND: It is needed in the treatment of yearly increased nervous and mental diseases to seek safe and effective sedatives and tranquilizers from natural drugs. It is found in the previous experiments that the total alkaloid of equisetum pratense (TAEP) has the satisfactory sedative and tranquitrzing actions.OBJECTIVE: To analyze the inhibitory effect of TAEP on the central nervous system.DESIGN: A randomized control study taking experiment animals as the observing objects.SETTING: The Post-doctor Scientific Research Station, Institute of Materia Medica, Harbin Shangye University.PARTICIPANTS: The experiment was carried out in the Department of Pharmacology, Heilongjiang University of Traditional Chinese Medicine between March 2002 and January 2003. The drug was TAEP, and 24 Wistar rats were used.METHODS: Twenty-four rats were randomly divided into 3 groups: TAEP group (60 mg/kg), reserpine group (30 mg/kg) and saline group (the same volume), all the rats were given intraperitoneal injections of the above drugs in corresponding dosages, and then the contents of monoamine neurotransmitters in brain were determined by high performance liquid chromatography (HPLC)-electrochemistry (HPLC-EC) and HPLC-ultraviolet (HPLC-UV) respectively.MAIN OUTCOME MEASURES: The contents of monoamine neurotranmitters of norepinephrine, adrenalin, dopamine and 5-serotonin (5-HA) and its metabolites of DHPR, 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid in the striatum and marginal area of brain in rats were observed.RESULTS: There were 8 rats in each group both before and after the experiment without abnormalities or death. TAEP significantly lowered the contents of monoamine neurotranmitter but increased the contents of neutral and acidic metabolites of monoamine neurotranmitters in the striatum of rats. TAEP significantly decreased the monoamine neurotranmitters and significantly elevated the contents of monoamine metabolites of 5-HIAA and homovanillic acid, but insignificantly increased the content of DHPR in the marginal area of brain (P ＞ 0.05).CONCLUSION: The sedative and tranquilizing actions of TAEP are associated with the decreased contents of central monoamine neurotranmitters. TAEP has an action on the evacuation of monoamine which is similar to reserpine, which may be considered as one of the mechanisms of its sedative and tranquitrzing actions on central nerve system.

OBJECTIVETo study the dose-response relationship between the quantitative morphological stereology on thyroid and different iodine doses in mice.

METHODSWeaning Kunming mice were randomly divided into seven groups. The mice were fed for 100 days with distilled water containing different KIO3 concentrations, i.e. 50, 250, 500, 1 000, 1 500, 2 000, and 3 000 microgram/L respectively. The 50 microgram/L (proper iodine concentration) group was control group, and the groups of 250 approximately 3 000 microgram/L were high iodine groups. The stereology parameters of thyroid follicle and follicular cavities were measured with HPIAS-1000 (High Resolution Pathological Image & word Analysis System). The stereology parameters included mean surface, volume on area, volume on circumference, specific surface, numerical density on area, spherical factor, the percentage of mean surface and mean volume of the follicular epithelial cell in thyroid follicle was further calculated.

RESULTSPositive correlations was observed between the thyroid absolute and relative weight, goiter rate and different iodine doses. And the thyroid absolute and relative weight of mice in the 250 microgram/L group was significantly different from that in 50 microgram/L group. The goiter rate of mice in different high iodine groups was in conformity with that of epidemiological investigation. The goiter rate of mice in 500 microgram/L group was different from that in 50 microgram/L group. Positive correlations were observed between mean surface, volume on area, volume on circumference, spherical factor and iodine doses, but the negative correlations were observed between numerical density on area, specific surface, the percentage of mean surface and mean volume of the follicular epithelial cell in thyroid follicle and iodine doses.

CONCLUSIONSWhen Iodine doses are between 250 approximately 3 000 microgram/L, the dose-response relationship was observed between the morphological stereology parameters of thyroid follicle and follicular cavities and iodine doses, and when the dose of iodine is 250 microgram/L, it is possible to induce colloid goiter of mice. The goiter rates of mice resulted by different high iodine doses were in conformity with that of the epidemiological investigation of people.

Animals ; Dose-Response Relationship, Drug ; Epithelial Cells ; drug effects ; Female ; Iodine ; adverse effects ; pharmacology ; Male ; Mice ; Organ Size ; Thyroid Gland ; drug effects ; pathology

Objective To evaluate the long-term results of extended parietal cell vagotomy (EPCV) for the treatment of acutely perforated duodenal ulcer. Methods EPCV was performed on 239 patients. Results were analyzed retrospectively. Results Follow up was made on 203 out of 239 patients (84.9%). There was no operative mortality. Inhospital complications included injury to the spleen in 4 cases (1.7%), adhesive ileus in 6(2.5%), acute diarrhea in 3 (1.3%), and postprandial epigastric distention in 18 (7.5%). Long-term complications included epigastric pain and sour regurgitation in 16 cases(7.8%), enterolysis in 4(1.9%), duodenal bulb allaxis in 39(18.2%), chronic gastritis in 21(10.3%), and recurrent ulcer in 6(2.9%). Basic acid output, maximal acid output and peak acid output decreased by 84.7%, 60.0%, and 58.0% respectively(all P

Objective To evaluate the safety and feasibility of sphincter-preserving transabdominal-anal excision of middle-lower rectal cancer by mucosa-mucosa coloanal anastomosis. Methods There were 169 cases undergoing this procedure including 107 males and 62 females. The low margins of the tumors located between 5~9 cm from the anal verge. Histopathological examination showed adenocarcinoma in 163 cases, mucinous adenocarcinoma in 6, and adenoma with canceration in 6.According to Dukes′ classification,61 belonged to Dukes′ A,101 Dukes′B, and 7 Dukes′C. Results Postoperative complications included stomal leak in 5 cases, stomal stenosis in 3, and defecation frequency increased to 6～12 times daily in all cases during the early stage and gradually back to normal 12～18 weeks postoperation. An average follow-up of 5.8 years was made in 154 cases(91.1%).Local recurrence was 5.8%.Hepatic metastasis was 13.7%.The five year survival rate was 66.9%. Conclusion This anal-sphincter preserving procedure while fulfilling radical resection for middle-lower rectal carcinoma is both safe and feasible alternative approach.