Influence of Pre-treatment Lymphocyte/Monocyte Ratio and Neutrophil/Lymphocyte Ratio on the Prognosis of Patients with Extranodal NK/T-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore the influence of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) on the prognosis of patients with extranodal NK/T cell lymphoma (ENKTL).@*METHODS@#The clinical data of 203 patients with ENKTL admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to January 2020 were retrospectively analyzed. The ROC curve determined the limit values of LMR and NLR; Categorical variables were compared using a chi-square test, expressed as frequency and percentage (n,%). Continuous variables were expressed as medians and extremes and compared with the Mann-Whitney U test; Progression-free survival (PFS) and overall survival (OS) of different grouped LMR and NLR patients were analyzed using Kaplan-Meier curves and compared with log-rank tests. The COX proportional risk regression model was used to perform one-factor and multi-factor analysis of PFS and OS.@*RESULTS@#The optimal critical values of LMR and NLR were determined by the ROC curve, which were 2.60 and 3.40, respectively. LMR≤2.60 was more likely to occur in patients with bone marrow invasion (P=0.029) and higher LDH (P=0.036), while NLR≥3.40 was more likely to occur in patients with higher ECOG scores (P=0.002), higher LDH (P=0.008), higher blood glucose (P=0.024), and lower PLT (P=0.010). Kaplan-Meier survival analysis showed that PFS and OS of patients in the high LMR group were significantly better than the low LMR group, while PFS and OS in the low NLR group were significantly better than the high NLR group. The results of multivariate COX analysis showed that EBV-DNA positive (P=0.047), LMR≤2.60 (P=0.014), NLR≥3.40 (P=0.023) were independent risk factors affecting PFS in patients with ENKTL. LMR≤2.60 (P<0.001), NLR≥3.40 (P=0.048), and high β2-MG (P=0.013) were independent risk factors affecting OS in patients with ENKTL.@*CONCLUSION@#Low LMR and high NLR before treatment are associated with poor prognosis in patients with ENKTL, which also can be used as an easily testable, inexpensive, and practical prognostic indicator in the clinic.

Application of a sleep electroencephalogram in the diagnosis of epilepsy in children / 中国基层医药

Objective:To investigate the significance of sleep electroencephalogram (EEG) monitoring in the diagnosis and differential diagnosis of childhood epilepsy.Methods:The clinical data of 56 children with epilepsy diagnosed in The Maternal and Child Health Hospital of Huainan from February 2020 to February 2022 were retrospectively analyzed. The relationship between the positive rate of epileptiform discharge under sleep EEG monitoring and its location and sleep phase was analyzed.Results:Of the 56 children, 36 (64%) children had normal results of routine awake EEG monitoring, and 20 (36%) children had abnormal results. Among the 56 children, 9 (16%) children had normal sleep and 47 (84%) had abnormal sleep. The difference in EEG monitoring results between the awake and asleep states was statistically significant ( χ2 = 27.08, P < 0.001). Among abnormal EEG in 47 patients, paroxysmal abnormality (epileptiform discharge) was found in 44 patients and non-specific abnormality was found in 3 patients. Among the 44 children with epileptic discharges, 5 (11%) had epileptic discharges during wakefulness, 11 (25%) children had epileptic discharges during a sleepless period, and 28 (64%) had epileptic discharges during a slight sleep period. EEG epileptiform discharges occurred in the central temporal region in 9 (21%) patients, temporal region in 8 (18%) patients, parieto-occipital region in 1 (2%) patient, frontal region in 5 (11%) patients, and the frontotemporal region in 6 (14%) patients. Generalized discharges were found in 14 (32%) patients, and generalized hypsarrhythmia was found in 1 (2%) patient. Conclusion:Children with clinically highly suspected epilepsy should be reexamined by sleep EEG if the routine awake EEG, monitoring results are normal, to reduce the rates of misdiagnosis and missed diagnosis in children with epilepsy.

Configuration and the safe use of standardized parenteral nutrient solution for preterm infants / 中国新生儿科杂志

Objective:To study the configuration and safety of standardized parenteral nutrition solution for premature infants.Methods:A retrospective cohort study was used to the premature infants who were admitted to the neonatal intensive care unit of the West China Second Hospital within 24 hours after birth, 28~34 weeks gestational age, and began parenteral nutrition within 48 hours after birth from June 2015 to November 2018. Electrolytes, blood sugar, phlebitis and venous catheter-related infection during the use of parenteral nutrient fluids were collected, and divided into standardized parenteral nutrient solution group and individualized parenteral nutrient solution group according to the types of parenteral nutrient fluids used. Data analysis is realized by using EmpowerStats statistical software based on R language.Results:A total of 840 premature infants were collected, among them, 541 cases of standardized parenteral nutrition solution group and 299 cases of individual parenteral nutrition solution group. Compared with the individual parenteral nutrition solution group, the incidence of hyperglycemia was 6.3% (34/541) vs. 21.7% (65/299), OR=0.491, 95% CI 0.268~0.899. The incidence of hypokalemia was 13.5% (73/541) vs. 59.9% (179/299), OR=0.137, 95% CI 0.090~0.208. The incidence of hypercalcemia was 25.9% (140/541) vs. 62.8% (188/299), OR=0.249, 95% CI 0.162~0.383. The incidence of hypophosphatemia was 0.2% (1/541) vs. 2.7% (8/299), OR=0.076, 95% CI 0.008~0.686. All the differences were statistically significant ( P<0.05) .There was no significant difference in the incidence of catheter-related infections between the two groups ( P>0.05). Conclusions:Standardized parenteral nutrition is safer in maintaining blood glucose, blood potassium and calcium and phosphorus metabolism in premature infants.

Randomized controlled trial outcome indicators of traditional Chinese medicine for gastrointestinal dysfunction in sepsis in recent two years / 中国中药杂志

The purpose of the study is to analyze the outcomes of randomized controlled trial(RCT) of Chinese herbal medicine formula(CHMF) in the treatment of gastrointestinal dysfunction in sepsis in recent two years. We systematically searched four Chinese databases, three English databases, and two clinical trial registries to analyze the reports of outcome indicators of clinical trials, and evaluated the risk of bias by using the ROB tool of Cochrane Collaboration. After screening, 55 clinical RCTs were included. The results showed that the current clinical studies of gastrointestinal dysfunction in sepsis reported the efficacy and safety indicators. The efficacy indicators included APACHE Ⅱ scores, gastrointestinal dysfunction scores, bowel sound scores, and inflammatory indicator such as C-reactive protein and procalcitonin. The safety indicators mainly include gastrointestinal reactions, skin reactions, and other adverse events and adverse reactions. However, there was no distinction between primary and secondary outcomes. The relevant indicators of health economics were not reported, and the quality of research methodology was poor. Therefore, we suggest that future researchers should be well prepared in the top-level design stage and actively construct the core outcome set, so as to improve the quality of clinical trials.

Isoleucine and energy metabolism / 中华内分泌代谢杂志

The prevalence of energy metabolism-related metabolic diseases, such as diabetes, fatty liver, and cardiovascular diseases, is trending upwards over years. Not only glucose and lipid metabolism but also amino acid metabolism are involved in the pathogenesis, among which branched-chain amino acids are most widely studied. Isoleucine is an important branched-chain amino acid. Its relevance to metabolic diseases has caught more attention in recent years. This review is to highlight advances in isoleucine and energy metabolism.

Study on middle-aged and elderly people′ willingness for family doctor contracting and its influencing factors / 中华医院管理杂志

Objective:To investigate the middle-aged and elderly people′ willingness for family doctor service contracts and its influencing factors, and to provide feasible suggestions for the implementation and promotion of family doctor services.Methods:Stratified random sampling method was adopted to select middle-aged and elderly people aged 45 in 6 urban areas of Xuzhou city for questionnaire survey to investigate their illness, medical treatment and their willingness to contract a family doctor. The data acquired were analyzed with statistical description, univariate analysis( χ2 test), and multivariate logistic regression analysis. Results:Among the 927 valid questionnaires were recovered, 272(29.34%)of them intended to contract a family doctor, and 655(70.66%)had no such intention. Results of multivariate logistic regression showed that the influencing factors of the middle-aged and elderly people′ willingness of contracting family doctors were age, occupation, self-rated health, treatment status within two weeks, chronic diseases, referral experience and their knowledge of family physician contract system.Conclusions:Middle-aged and elderly people at large are not willing to sign up for family doctors. It is recommended to focus the publicity efforts on those who are relatively younger age, farming and healthier, enhancing their awareness of the service, and encouraging them to support the dual-referral policy. These efforts are expected to promote the coordinated progress of both dual referral and family doctor contract service, hence achieving the national coverage of the family doctor system.

Interaction study of the antibacterial peptide urumin with the H1N1 HA protein of influenza A virus / 药学学报

Influenza A virus (H1N1) seriously affects the health of human and disrupts the development of global economic. The antimicrobial peptide urumin specifically binds to the conserved stem of the hemagglutinin (HA) protein of H1N1 virus, but its binding site and the mechanism of action are not clear. In this study, we investigated the possible binding sites and key amino acids for the interaction of urumin with HA protein by molecular docking and enzyme-linked immunosorbent assay (ELISA) experiments, suggesting that HA residues His32 (HA1), Asp19 (HA2), and Trp21 (HA2) are the key residues for the interaction of HA with urumin. Urumin's Arg4, Asn9, and Cys16 were associated with HA protein residues Asp19 (HA2), Trp21 (HA2), His32 (HA1), and Asn53 (HA2) form hydrogen bonding interactions, and Trp12 forms an aromatic π-stacking interaction with His32 (HA1) of HA, these interactions maintain the binding of urumin to HA protein. Wild-type HA and its alanine mutant [alanine substitutions His32 (HA1), Asp19 (HA2), and Trp21 (HA2)] were expressed in 293T cells. ELISA experiments showed that the affinity ability of urumin with HA wild-type was significantly higher than that of HA alanine mutant, suggesting that His32 (HA1), Asp19 (HA2), and Trp21 (HA2) may be the key residues for HA to interact with urumin. This study provides a theoretical and experimental basis for further modification and application of urumin.

Effects of patient participation -based dietary intervention on nutritional status for patients with severe burns / 中国实用护理杂志

Objective:To explore the influence of patient participation-based dietary intervention on nutritional status for patients with severe burn.Methods:From September 2017 to January 2019, 60 severe burn patients hospitalized in the department of burn and plastic surgery of Qingdao Municipal Hospital were recruited and divided into the experimental group ( n=30) and the control group ( n=30) according to the random number table method. The control group received a regular diet. While the experimental group received a patient participation-based dietary intervention(PPDI), The wound healing time and the value of nutritional status index, such as height, body mass index(BMI), serum albumin, serum prealbumin, in the two groups on admission, at 2 weeks after intervention, 4 weeks after intervention were compared. The nutritional knowledge questionnaire of burn patients and "3-day diet diary" were used for investigation. Results:The score of nutritional knowledge showed no significant difference between the two groups before intervention. After intervention, the score of nutritional knowledge in the experimental group was 21.40±2.42, significantly higher than that in the control group (19.00±2.26) ( t value was 3.975, P<0.01). For time effect and between-group effect, there were significant difference in serum albumin between two groups ( F values were 9.232, 4.651, P<0.05); the time effect and between-group effect of serum prealbumin were statistically significant ( F values were 11.592, 6.228, P < 0.05). The wound healing time in the experimental group was significantly lower than that in the control group ( t value was -3.801, P<0.01). Conclusions:Patient participation-based dietary intervention can effectively enhanced the level of nutritional knowledge, improved nutritional status, shortened wound healing time among patients with severe burn.

Expression and clinical significance of lysophosphatidic acid receptor 5 protein in breast cancer / 中国基层医药

Objective@#To investigate the expression and clinical significance of lysophosphatidic acid receptor 5 (LPA5) protein in breast cancer tissues.@*Methods@#The specimens of breast cancer tissues and adjacent tissues of 80 breast cancer patients from January 2015 to December 2016 in the First People's Hospital of Yongkang were selected in the study.The expression of LPA5 in breast cancer tissues and adjacent tissues was determined by immunohistochemistry.The clinical case characteristics of patients were collected.@*Results@#The positive expression rate of LPA5 in breast cancer tissues(72.5%) was higher than that in adjacent tissues(8.75%)(χ2=67.394, P<0.05). The positive rate of LPA5 in clinical stage Ⅲ-Ⅳ(91.3%) was higher than that in stage Ⅰ-Ⅱ(64.9%)(χ2=5.725, P<0.05). The positive rate of LPA5 in patients with lymph node metastasis(94.7%) was higher than that in patients without lymph node metastasis(52.4%)(χ2=17.951, P<0.05). The positive rate of LPA5 in patients with intravascular tumor thrombus(92.3%) was higher than that in patients without intravascular tumor thrombus (63.3%)(χ2=7.580, P<0.05). The expression of LPA5 in breast cancer tissues was not related to age and tumor diameter (P>0.05). There were no significant differences in the positive expression rates of LPA5 in the breast cancer tissues among luminal type, human epidermal growth factor receptor 2 (Her2) overexpressing type and triple negative type (P>0.05). The disease-free survival rate(86.3%) and overall survival rate(87.5%) of patients with negative expression of LPA5 in breast cancer tissues were higher than those in breast cancer tissues with positive expression (65.0%, 66.3%)(χ2=4.517, 4.328, all P<0.05).@*Conclusion@#LPA5 expression is up-regulated in breast cancer tissues, and LPA5 may be involved in the development and progression of breast cancer, which is closely related to the prognosis of breast cancer.

Expression and clinical significance of lysophosphatidic acid receptor 5 protein in breast cancer / 中国基层医药

Objective To investigate the expression and clinical significance of lysophosphatidic acid receptor 5 (LPA5) protein in breast cancer tissues.Methods The specimens of breast cancer tissues and adjacent tissues of 80 breast cancer patients from January 2015 to December 2016 in the First People's Hospital of Yongkang were selected in the study.The expression of LPA5 in breast cancer tissues and adjacent tissues was determined by immunohisto-chemistry.The clinical case characteristics of patients were collected.Results The positive expression rate of LPA5 in breast cancer tissues (72.5%) was higher than that in adjacent tissues (8.75%) (χ2 ＝67.394,P＜0.05).The positive rate of LPA5 in clinical stage Ⅲ-Ⅳ(91.3%) was higher than that in stage Ⅰ-Ⅱ(64.9%)(χ2 ＝5.725, P＜0.05).The positive rate of LPA5 in patients with lymph node metastasis (94.7%) was higher than that in patients without lymph node metastasis (52.4%)(χ2 ＝17.951,P＜0.05).The positive rate of LPA5 in patients with intravascular tumor thrombus ( 92.3%) was higher than that in patients without intravascular tumor thrombus (63.3%)(χ2 ＝7.580,P＜0.05).The expression of LPA5 in breast cancer tissues was not related to age and tumor diameter (P＞0.05).There were no significant differences in the positive expression rates of LPA 5 in the breast cancer tissues among luminal type ,human epidermal growth factor receptor 2 (Her2) overexpressing type and triple negative type (P＞0.05).The disease-free survival rate(86.3%) and overall survival rate (87.5%) of patients with negative expression of LPA5 in breast cancer tissues were higher than those in breast cancer tissues with positive expression (65.0%,66.3%)(χ2 ＝4.517,4.328,all P＜0.05).Conclusion LPA5 expression is up-regulated in breast cancer tissues,and LPA5 may be involved in the development and progression of breast cancer ,which is closely related to the prognosis of breast cancer.

Effects of Dingkun Dan combined with Western medicine on endometrial β-catenin, VEGF and MMP-9 mRNA expression in rats with multiple lesions / 中国中药杂志

The aim of this paper was to investigate the effect of Dingkun Dan on endometrial receptivity in rats with multiple lesions. Forty SD female rats with regular sexual cycle were randomly divided into 5 groups, control group, model group, progynova group, Dingkun Dan group and combination group. The thin endometrium model of kidney-yang deficiency was established in all the other rats except normal control group. The rats in normal control group were free to drink and eat; the rats in the model group were administered with distilled water; the rats in the progynova group were treated with progynova; rats in Dingkun Dan group were treated with Dingkun Dan, and the rats in combination group were treated with Dingkun Dan and progynova. After 15 days, serum levels of OPN, VEGF and MMP-9 were measured by ELISA. HE staining, immunohistochemistry and RT-PCR were used to analyze endome-trial morphology, endometrial thickness and the treatment mechanism of Dingkun Dan. As compared with the control group, the serum levels of OPN, VEGF and MMP-9 in the model group were significantly increased(P<0.01). As compared with the model group, the serum levels of OPN and MMP-9 were decreased in Dingkun Dan group(P<0.05, P<0.01). As compared with the control group, endometrial stromal cells were fewer, the endometrium glands and blood vessels were sparse, and the endometrium was thinner significantly in the model group(P<0.01). As compared with the model group, there were more endometrial glands, rich intimal vessels, and dense stromal cells in various treatment groups, and the endometrium were thickened significantly in the treatment groups(P<0.01). As compared with the control group, the expression area of CK19 in the model group was decreased significantly(P<0.01). As compared with the model group, the expression area of CK19 in each treatment group was increased significantly(P<0.05). As compared with the control group, endometrial β-catenin and MMP-9 mRNA expression levels were increased significantly in the model group(P<0.05), while VEGF mRNA expression was decreased(P<0.05). As compared with the model group, MMP-9 mRNA expression was decreased significantly in the progynova group and the combination group(P<0.05). Dingkun Dan combined with progynova can improve endometrial receptivity by up-regulating expression of β-catenin, VEGF mRNA and down-regulating the expression of MMP-9 mRNA in the injury rats.

Analysis of awareness of HIV/AIDS-related knowledge and related behavior among men who have sex with men (MSM) in Changsha / 中华疾病控制杂志

@# Objective To understand the awareness of HIV/AIDS-related knowledge and characteristics of sexual behaviors among men who have sex with men (MSM) in Changsha City. Methods By a snowball sampling method, volunteers were recruited in two social public welfare organizations in Changsha (Qingcai and Zhongda Sunshine) and interviewed by anonymous electronic questionnaires. Data were analyzed using software SPSS 19.0. Results Among 150 MSM, the overall awareness rate of HIV/ AIDS-related knowledge was 86.0% (129/150). For different demographic characteristics, higher age group, higher education level and higher income groups had significantly higher rates of awareness about HIV/AIDS related knowledge, compared with the reference groups, respectively. For the sexual behaviors, 32.7% of the investigated MSM population had their first MSM sexual intercourse at age of <18 years old, the rate of ≥18 years old group was significantly higher than the <18 years old group (2=4.315, P=0.038), 46.7% of the MSM population had more than 1 sexual partner during the past six months, the ratio of MSM used condoms in the sexual intercourse occasionally or never was 29.3% and 6.7%, respectively. Conclusions Young age, relatively low educational level and low income MSM in Changsha had a relative low awareness of HIV/AIDS-related knowledge. MSM in Changsha City had first MSM sexual intercourse at a very younger age. There is an urgent need to take well-targeted measures to improve the HIV/AIDS-related knowledge with special MSM population, and develop effective intervention measures for the high-risk sexual behaviors among MSM.

Improved stability and oral bioavailability of Ganneng dropping pills following transforming lignans of herpetospermum caudigerum into nanosuspensions / 中国天然药物

The present study was designed to improve storage stability and oral bioavailability of Ganneng dropping pills (GNDP) by transforming lignans of Herpetospermum caudigerum (HL) composed of herpetrione (HPE) and herpetin (HPN) into nanosuspension (HL-NS), the main active ingredient of GNDP, HL-NS was prepared by high pressure homogenization and lyophilized to transform into solid nanoparticles (HL nanoparticles), and then the formulated HL nanoparticles were perfused into matrix to obtain NS-GNDP by melting method. For a period of 3 months, the content uniformity, storage stability and pharmacokinetics test in vivo of NS-GNDP were evaluated and compared with regular GNDP at room temperature. The results demonstrated that uniformity of dosage units of NS-GNDP was acceptable according to the criteria of Chinese Pharmacopoeia 2015J. Physical stability of NS-GNDP was investigated systemically using photon correlation spectroscopy (PCS), zeta potential measurement, and scanning electron microscopy (SEM). There was a slight increase in particles and PI of HL-NS re-dispersed from NS-GNDP after storage for 3 months, compared with new formulated NS-GNDP, which indicated a good redispersibility of the NS-GNDP containing HL-NS after storage. Besides, chemical stability of NS-GNDP was studied and the results revealed that HPE and HPN degradation was less when compared with that of GNDP, providing more than 99% of drug residue after storage for 3 months. In the dissolution test in vitro, NS-GNDP remarkably exhibited an increased dissolution velocity compared with GNDP and no distinct dissolution difference existed within 3 months. The pharmacokinetic study showed that HPE and HPN in NS-GNDP exhibited a significant increase in AUC, C and decrease in T when compared with regular GNDP. These results indicated that NS-GNDP possessed superiority with improved storage stability and increased dissolution rate and oral bioavailability.

Evaluation and countermeasure study on hospital safety culture based on statistic quality control / 中华医院管理杂志

Objective To measure and evaluate the construction of hospital safety culture, analyze the present situation and problems of hospital safety culture construction, and put forward strategy of continuous improvement. Methods Based A tertiary hospital in northern Jiangsu province was chosen for the survey. Sampling questionnaire survey was made to 400 staff of the hospital, including directors/vice directors of clinical departments, chief nurses and logistic/administrative staff(10％ of the total staff). These people were subject to a questionnaire survey of Hospital Safety Culture Measurement regarding hospital safety culture status and satisfaction. Likert 5-point scale and assign points, statistical inference, and quality control chart method were used, to analyze the organization structure, medical quality and medical safety, comprehensive evaluation dimensions of hospital safety culture, as well as 31 items involved. Results The agreement/satisfaction scoring of the general evaluation dimension of hospital safety culture was 67. 10％ as in agreement and 23. 20％ as high agreement; the scoring of the organization structure ( management capability of department managers and medical worker staffing) and medical safety( failure to report adverse events and discussion of patient privacy ) for hospital safety culture development was low ( 3. 4167 and 3. 5009 respectively). This calls for improvement. Conclusions The hospital should perform continuous monitoring and improvement, and strengthen the organizational work of safety culture hospital wide ( especially department managers) . It should also enhance the management of medical quality( ensuring drug supply, and service management awareness of logistic departments), and pay attention to medical safety monitoring and management for higher responsiveness of the hospital.

Study on residents'acceptance and influencing factors of the hierarchical medical system in Xuzhou / 中华医院管理杂志

Objective To investigate the residents' acceptance and the influencing factors of the hierarchical medical system in Xuzhou, and to suggest on effective system implementation. Methods Xuzhou residents free of cognitive impairment and over 18 years old were sampled for questionnaire survey in July-August 2016, to study their acceptance of their basics and acceptance of the system. 1 550 questionnaires were distributed, and 1 473 valid ones were recovered. The count data were expressed as constituent ratio, and χ2test was used for single-factor analysis, with binary logistic regression analysis for multi-factor analysis. Results 71. 0% of the residents embraced this system. Their acceptance varies significantly with their age, place of residence, education, annual average monthly income, self-rated health status, physical examination experience, conditions of chronic diseases, medical visit experience at primary healthcare institutions, and their awareness of the system (P<0.05). Conclusions The acceptance of the system by Xuzhou residents needs to be elevated, by means of greater promotional efforts, capacity building for primary institutions, so as to fully leverage the system to serve the residents.

Case Analysis on GLP-1 Preparation Used in 3 T2DM Patients with Hepatic Insufficiency and Obesity / 中国药师

Clinical pharmacists actively participated in the glucose-lowering therapy for three type 2 diabetes patients with obesity and hepatic insufficiency to explore the role of clinical pharmacists in clinical treatment. Through the participation in the formulation of drug treatment by clinical pharmacists, GLP-1 preparation was used for hypoglycemic treatment, and the effect was promising. There was no significant change in the patients' liver function. By actively participating in the formulation of glucose-lowering therapy, clini-cal pharmacists can improve the effectiveness and safety of drug treatment.

Analyzing the Impact of the NRCMS Polices on the Utilization of Outpatient Services in Rural Resident Based on the Balanced Panel Data / 中国卫生统计

Objective To analyze the influence of NRCMS polices evolutionon residents’utilizationof outpatient serv-ices.Methods Based on the same individual balance panel data in two years of three counties in Ji＇nan city,we build panel dat-amodel and conductrandom effects of binary choice panel data model,random effects Poisson regression model,difference in differences(DID)model to analyze the influence.Results Our study shows that the four-week consultation rate in 2011 in-creased by 4. 1% compared to 2008.Age,self-ratedhealthstatus,suffering from chronic diseases or not,the distance to the nearest medical institution have an influence on outpatient service utilization.The new rural cooperative medical outpatient reimburse-ment policy has an effect on thefour-week consultation rate of middle-income residents and high-income residents.The NCMS policy tends to benefit middle and high-income groups.Conclusion we should increase NCMS outpatient compensation level of low-income residents appropriately.

Application of micro-lecture in construction of immunologic technology course / 中国免疫学杂志

Currently,the quick development of information technology is enriching the traditional teaching.As a new form of teaching resource,a micro-lecture focused on a specific topic is a good combination of information technology and traditional teaching.It not only increases the vividness and visualization of teaching,but also boosts the learning interest of students in the course.What's more,it helps to show an integral time-consuming experiment in 5-10 minutes'micro-vedio,which broadens the contents of the course and offers convenience of self-teaching for students.In this article,we took the example of micro-lecture"Western blot"in the course of immunologic technology to post-graduates in Shanghai University of Traditional Chinese Medicine to clarify the advantages and the procedures of a typical micro-lecture,and to discuss about it.The experience achieved from the construction of this micro-lecture may offer a new idea of modern information education reform.

Effect of Acupuncture plus Rehabilitation Training on Upper Limb Functional Recovery in Stroke Patients / 上海针灸杂志

Objective To investigate the effect of acupuncture plus rehabilitation training on upper limb functional recovery in convalescent stroke patients.Methods One hundred and three convalescent stroke patients with upper limb motor dysfunction were randomized to a treatment group (54 cases) and a control groups (49 cases). Both group received conventional rehabilitation training. In addition, the treatment group received along-meridian syndrome differentiation-based acupuncture and the control group, sham acupuncture. Upper limb Fugl-Meyer Assessment (U-FMA) score, the Wolf Motor Function Test (WMFT) score, the modified Barthel Index (MBI) score and the 36-Item Short Form Health Survey (SF-36) score were recorded in the two groups of patients before and at the end of treatment and at the 3-month follow-up.Results In the two groups there were statistically significant differences in the U-FMA score, the WMFT score and the MBI score at the end of treatment and the 3-month follow-up compared with before (P>0.05 orP<0.01). At the end of treatment and the 3-month follow-up there were statistically significant differences in the U-FMA score, the WMFT score and the MBI score between the treatment and control groups (P<0.05 orP<0.01). The scores of SF-36 items except social functioning and bodily pain had statistically significant differences within the two groups at the end of treatment and the 3-month follow-up compared with before and between the two groups at the end of treatment and the 3-month follow-up (P<0.01 orP<0.05).Conclusion Acupuncture plus rehabilitation training can markedly improve upper limb function in stroke patients.

Research Progress on Non-Drug Treatment for Blood Glucose Control of Type 2 Diabetes Mellitus / 中国结合医学杂志

Type 2 diabetes mellitus (T2DM) is one of the common endocrinology diseases that greatly affects the health care sector and economy. Application of hypoglycemic drugs has its own drawbacks and the use of non-drug therapy on treating T2DM has drawn much attention recently. This paper reviewed the research development of the non-pharmacological interventions on T2DM in recent years, including dietary therapy, exercise therapy, psychotherapy, acupuncture and moxibustion therapies and so on. The authors mentioned the problems in the research of non-drug treatment for blood glucose control of T2DM and put forward new ideas for the research in the future. Further well-designed trials with large sample size and long-term follow-up are needed to confirm current conclusions.