Immune cell membrane-based biomimetic nanomedicine for treating cancer metastasis

Metastasis is the leading cause of cancer-related death. Despite extensive treatment, the prognosis for patients with metastatic cancer remains poor. In addition to conventional surgical resection, radiotherapy, immunotherapy, chemotherapy, and targeted therapy, various nanobiomaterials have attracted attention for their enhanced antitumor performance and low off-target effects. However, nanomedicines exhibit certain limitations in clinical applications, such as rapid clearance from the body, low biological stability, and poor targeting ability. Biomimetic methods utilize the natural biomembrane to mimic or hybridize nanoparticles and circumvent some of these limitations. Considering the involvement of immune cells in the tumor microenvironment of the metastatic cascade, biomimetic methods using immune cell membranes have been proposed with unique tumor-homing ability and high biocompatibility. In this review, we explore the impact of immune cells on various processes of tumor metastasis. Furthermore, we summarize the synthesis and applications of immune cell membrane-based nanocarriers increasing therapeutic efficacy against cancer metastases via immune evasion, prolonged circulation, enhanced tumor accumulation, and immunosuppression of the tumor microenvironment. Moreover, we describe the prospects and existing challenges in clinical translation.

Anti-neutrophil cytoplasmic antibodies-associated glomerulonephritis in human immunodeficiency virus infection: a case report and literature review / 中华肾脏病杂志

Anti neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a systemic disease characterized by small vessel wall inflammation and cellulose necrosis mediated by ANCA. Renal injury caused by AAV is called ANCA-associated glomerulonephritis (AAGN). The paper reported a case of AAV with renal damage combined with human immunodeficiency virus (HIV) infection. The patient was an elderly male with clinical manifestations of hematuria and uremia. Renal pathological examination showed AAV and renal injury. This case is the first report in China while reviewing the relevant literature, and it is still inconclusive whether this is an overlap of the two diseases or a specific pathological type of HIV-associated nephritis. We believe that AAV has the potential to occur in HIV-infected patients, so clinicians should not ignore the phenomenon of ANCA positivity in HIV-infected patients, and the follow-up of such patients needs to be enhanced. Clinical and renal pathological examinations are the main methods to diagnose HIV infection with AAV. At the same time, there are no clear guideline guidelines on how to administer immunosuppressive therapy for such patients who have immunodeficiency and are at higher risk of opportunistic infections, and in whom to make the best possible outcomes.

Expression and characterization of recombinant wheat quiescin sulfhydryl oxidase and its effect on bread quality / 生物工程学报

Wheat quiescin sulfhydryl oxidase was expressed in Escherichia coli for developing a new biological flour improver. The synthesized wqsox gene was constructed into the vector pMAL-c5x and expressed in E. coli, then the expression conditions of recombinant protein was optimized. The MBP fusion label in recombinant protein was removed by protease digestion after affinity purification. Moreover, enzymatic properties of the purified wQSOX and its effect on bread quality were investigated. The synthesized wqsox gene contained 1 359 bp and encoded 453 amino acids with a deduced molecular weight of 51 kDa. The constructed recombinant vector pMAL-c5x-wqsox could successfully express soluble recombinant protein MBP-wQSOX in E. coli Rosetta gamiB(DE3), and the optimal induced expression conditions for recombinant protein were 25 °C, 0.3 mmol/L IPTG and 6 h. MBP fusion tag was cut out by factor Xa protease and wQSOX was prepared after affinity purification. wQSOX could catalyze the oxidation of DTT, GSH and Cys, accompanying the production of H2O2, and exhibited the highest substrate specificity for DTT. Furthermore, enzymatic properties results demonstrated that the optimal temperature and pH for wQSOX catalyzing oxidation of DTT was 50 °C and 10.0, respectively, and wQSOX presented a good stability under high temperature and alkaline environment. The addition of wQSOX with 1.1 U/g flour significantly (P<0.05) increased 26.4% specific volume of the bread, and reduced 20.5% hardness and 24.8% chewiness of bread crumb compared to the control, indicating a remarkable ability to improve the quality of bread.

Clinical Effect of Pedicled Pericardial Fat Flap in Prevention of Bronchial Pleural Fistula in Bronchial Sleeve Lobectomy / 中国肺癌杂志

BACKGROUND@#Bronchial sleeve lobectomy is essential surgical approach to treat centralized lung cancer. It is the best reflected the principle of lung cancer surgery, "remove tumor completely while minimize pulmonary function loss". Bronchial pleural fistula (BPF) is not common but very severe complication of bronchial sleeve lobectomy, that is usually fatal. Present article is to explore clinical effect on prevention of bronchial pleural fistula (BPF) in bronchial sleeve lobectomy, by wrapping brachial anastomosis with pedicled pericardial fat flap.@*METHODS@#Clinical data of 39 non-small cell lung cancer (NSCLC) patients who underwent surgical resection during January 2016 to May 2019 in Lung Cancer Center of West China Hospital, Sichuan University were collected and retrospectively analyzed. All of the patients underwent bronchial sleeve lobectomy and a brachial anastomosis wrapping with pedicled pericardial fat flap.@*RESULTS@#All patients recovered well and were discharged within 6 d-14 d after operation. No BPF occurred, nor other severe complications, such as reoperation needing intrathoracic bleeding, several pneumonia and respiratory failure, and life threatening cardiac arrhythmia. Only one patient (1/39) had several anastomotic stenosis and consequential atelectasis of residual lung in operative side 6 months after surgery.@*CONCLUSIONS@#Wrapping bronchial anastomosis with pedicled pericardial fat flap in bronchial lobectomy for centralized NSCLC is a simple and effective approach to prevent BPF, thus safety of the operation could be significantly improved.

Association between self-reported snoring and hypertension among Chinese Han population aged 30-79 in Chongqing, China

BACKGROUND@#We aim to explore the association between self-reported snoring and hypertension among adults aged 30-79 in Chongqing, China.@*METHODS@#A total of 23,342 individuals aged 30-79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension.@*RESULTS@#Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45-59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34-2.02; 45-59: OR = 1.53, 95%CI 1.37-1.72; ≥ 60: OR = 1.25, 95%CI 1.09-1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33-1.63; women: OR = 1.97, 95%CI 1.75-2.23).@*CONCLUSIONS@#People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.

Effects of chronic intermittent hypoxia on blood pressure and vascular remodeling / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate blood pressure and vascular remodeling of OSAS by establishing the chronic-intermittent hypoxia model in rat.@*Methods@#Experiments were performed on 35 adult male Sprague-Dawley rats. Animals were randomly divided into four groups: unhandled control group (with 5 rats in it), CIH group at 9/6/3 weeks (with 10 ratsin each group). Rats in CIH group went through 8-hour intermittent hypoxia everyday, and those in control group were raising normally. After 9-week experiment, blood pressure was measured. The changes of the following indexes were observed: pathological changes of aorta and the middle aorta thickness (HE staining), the collagen of aorta wall (Masson staining). The experimental data were analyzed by SPSS 24.0 statistical software. The variance was analyzed by one-way analysis of variance, and the irregularity was selected using the calibration t test.@*Results@#The systolic and diastolic blood pressures of the CIH9, 6, and 3 weeks groups and the control group were: (127±13) and (79±9), (124±11) and (81±7), (101±11) and (75±9), (91±10) and (65±9) mmHg (1 mmHg=0.133 kPa). The systolic blood pressure and diastolic blood pressure of the rats in the week of CIH 9 and 6 weeks were significantly higher than the control group (F=14.64, P=0.000; F=6.81, P=0.000). There was no significant difference in the mean blood pressure between the three groups of CIH and the control group. Membrane thickness in CIH9, 6 and 3 weeks and control group were: (20±2), (19±2), (14±2), (13±3) μm. Compared with the control group, the aortic pathology and thickness of the middle layer of the CIH9 and 6 weeks group were significantly thicker (F=20.24, P=0.000), but there was no significant difference between the CIH3 week group and the control group; the collagen deposition was unchanged compared with the control group.@*Conclusion@#Intermittent hypoxia for 6 weeks or more in rats resulted in the increasement of blood pressure, morphological changes of aorta and vascular remodeling in thickened media.

Review of spring-assisted surgery in craniosynostosis / 中华整形外科杂志

Traditional total cranial vault reconstruction for craniosynostosisis traumatic with long operative time and many serious complication. A brand new surgery technique, spring-assisted surgery(SAS), has been invented and performed for 20 years. It showed that SAS has the advantages of less invasive and good result. It has gradually become one of the important methods to treat early craniosynostosis. This article reviewed the SAS related literatures in the past 20 years, focusing on various surgical methods of SAS and possible surgical complications. The osteogenesis principle, prognosis and development of SAS were also summerized.

The clinical significance of AT-rich interaction domain 3a+ B cell change in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective@#To investigate the expression of transcription factor AT-rich interaction domain 3a (ARID3a) in peripheral blood B cells of patients with systemic lupus erythematosus (SLE) and its clinical significance.@*Methods@#Peripheral blood mononuclear cells were isolated from 17 SLE patients and 13 healthy controls. Then, the expression of ARID3a by B cells was determined by flow cytometry. Data was analyzed with independent sample t test. The correlations between the frequencies of ARID3a+ B cells and clinical indicators of SLE patients were assessed by Pearson cor relation analysis. The expression of ARID3a in kidney was detected by immunohistochemistry in 14 cases of lupus nephritis (LN).@*Results@#The percentages of ARID3a+ B cells in SLE patients [(51.6±3.2)%] were significantly higher than those in healthy controls [(32.6±3.4)%](t=4.0, P<0.01). There was a positive correlation between the percentages of ARID3a+ B cells in SLE patients and their 24-hour urinary protein (r=0.68, P<0.05). Furthermore, the percentages of ARID3a+ B cells in peripheral blood from patients with active LN[(62.3±4.3)%] were remarkably higher than that from patients without LN or with inactive LN [(43.3±2.8)%] (t=3.8, P<0.01). The expression of ARID3a in glomerula and tubules of LN patients markedly increased.@*Conclusion@#Elevated expression of transcription factor ARID3a in B cells may participate in the pathogenesis of LN.

Mutation analysis of two pedigrees with suspected oculocutaneous albinism / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical presentation and gene of 2 pedigrees with suspected oculocutaneous albinism(OCA), and provide basis for clinical classification, genetic counseling and prenatal diagnosis.@*METHODS@#Variants were identified using next-generation sequencing(NGS) and confirmed by Sanger sequencing in 2 pedigrees with suspected OCA. The pathogenicity of the variants was analyzed according to the American College of Medical Genetics and Genomics (ACMG) standard.@*RESULTS@#Two compound heterozygous mutations of TYR and OCA2 genes were identified respectively in 2 pedigrees with suspected OCA. The mutation of c.819+3insATATGCC in TYR and the mutation of c.1870G>C in OCA2 are first reported in this study. The pathogenicity analysis shows that two novel mutations are likely pathogenic by combination of prediction of SIFT, Polyphen-2 and Human Splicing Finder.@*CONCLUSION@#The findings of this study expand the mutational spectrum of OCA. Compound heterozygous mutations in the TYR and OCA2 gene may be responsible for clinical manifestations of 2 pedigrees with suspected OCA.

Application of ultrasound-guided thoracic paravertebral nerve block in percutaneous kyphoplasty / 中华全科医师杂志

From January 2016 to June 2017, 68 patients with thoracic osteoporotic compression fractures were treated with percutaneous kyphoplasty, including 31 cases with ultrasound-guided thoracic paravertebral nerve block (group A) and 37 cases with local anesthesia (group B). The duration of analgesia in group A was longer than that in group B (P<0.05). The satisfaction of anesthesia in group A was higher than that in group B (90% vs. 68%, P<0.05). There was no significant difference in length of hospital stay and cost between the two groups (P>0.05). The post-operative VAS scores was significantly lower than those of pre-operation in both groups (P<0.05). The intraoperative VAS score of group A was lower than that of group B (P<0.05). There was no significant difference between the two groups in mean arterial pressure and heart rate (P>0.05). No cardiovascular and cerebrovascular adverse reactions occurred in both groups. Ultrasound-guided thoracic paravertebral nerve block is a safe and effective method used in percutaneous kyphoplasty.

Comprehensive therapy of facial contour in auriculo-condylar syndrome: clinical experience / 中华整形外科杂志

Objective@#To present the overall therapy to correct mandible deformities and modify facial contour of patients who have been diagnosed as auriculo—condylar syndrome (ACS) in our hospital.@*Methods@#We formulate effective therapeutic plan for every single patient based on digital surgical techniques. Three patient received individualized therapy, which include bilateral Distraction osteogenesis, orthodontic treatment, genioplasty, LeFort Ⅰ osteotomy, Chin augmentation with porous polyethylene implant, or mandibular contour correction with porous polyethylene implant.@*Results@#All three patients gained satisfactory surgical results. Occlusal function and sleeping quality in 2 severe patients was significantly improved.@*Conclusions@#Clinical features of ACS is complex, which may range from mild to severe in different patients. Individualized therapeutic plan of comprehensive treatment should be established after facial deformity evaluation and surgical simulation based on surgical techniques.

The study of the maximum bite force after mandibular distraction osteogenesis in hemifacial microsomia deformities / 中华整形外科杂志

Objective@#To investigate the influence of mandibular distraction osteogenesis on masticatory function by analyzing the maximal bite force before and after surgery.@*Methods@#From May 2014 to November 2015, 22 hemifacial microsomia cases, ageing from 6 to 10 years old, underwent mandibular distraction osteogenesis and their biting force data were collected. The maximal bite forces in incisor area, bilateral premolar area and molar area were measured before surgery and 1 year after surgery.@*Results@#The average maximum bite forces in the molar area of the affected side, premolar area of the affected side, incisor area, premolar area of the unaffected side, molar area of the unaffected side were (170.6±42.8)N, (141.9±34.9)N, (89.7±18.8)N, (169.3±29.0)N and (230.2± 56.4)N respectively before surgery. Statistics indicated that most patients had uneven distribution of bite force between the affected side and unaffected side before surgery. And they changed to (198.8±44.0)N, (151.8±31.1)N, (88.9±18.0) N, (167.8±26.1)N and (234.3±52.5)N respectively 1 year after surgery, showing that the bite force in the molar area of the affected side was significantly improved by the surgery(P<0.05). Regression analysis showed that the postoperative bite force distribution had a tendency to become more symmetrical in hemifacial microsomia patients.@*Conclusions@#Mandibular distraction osteogenesis can improve the bite force of the affected side in hemifacial microsomia patients and enhance the balance of masticatory in the long-term postoperatively.

Establishment of electron beam computed tomography and rapid prototyping techniques for a cranial bone defect model in goat / 中华医学美学美容杂志

Objective To establish a cranial bone defect model of goat and to study application in craniomaxillo-facial surgery.Methods Electron beam computed tomography (EBCT) scanner was used to scan goat'heads and faces in series and thin layers.Data of EBCT were input in workstation from digital inlet,and then to three-dimensional reconstruction with method of surface shadow.After final data were transformed to the files,the rapid prototyping machine was able to identify and establish the 3D model.Results The EBCT continuous thin-layer (1 mm) scanning data were passed to wave filter,falling coarse,distinguishing and collecting the outline,3D-reconstruction,curved surface reconstruction with CAD and the substance reconstruction.The final data were input into the laser rapid prototyping machine.Three-dimensional bionic cranium models were fabricated by machine in layer by layer manufacturing principle.Conclusions Establishment of the cranial bone defect model in the goat is very useful to the three-dimensional measurement,individualized reconstruction and basic and clinical research for the cranial bone defect.

Up-regulation of soluble vascular endothelial growth factor receptor 1 expression in co-culture of human umbilical cord-derived mesenchymal stem cells and rheumatoid arthritis fibroblast-like synoviocytes / 中华风湿病学杂志

Objective To investigate the expression of soluble vascular endothelial growth factor receptor 1 (sFlt1) in human umbilical cord-derived mesenchymal stem cells (HUCMSC) under the condition of inflammatory cytokine and co-culture with rheumatoid arthritis fibroblast-like synoviocytes (RA-FLSs).Methods ① HUCMSC were cultured alone or stimulated by Tumour necrosis factor (TNF)-αt,interferon (IFN)-γor the combination of TNF-α and IFN-γ.The sFh1 levels of each group were detected by enzyme-linked immunosorbent assay (ELISA) at 24 h,48 h and 72 h respectively.② RA-FLSs and HUCMSC were cocultured in a transwell system with both of them cultured alone as control for 72 hours.ELISA was used to detect sFlt1 levels in each group.T test was used for comparison between two groups,and ANOVA was used to compare multi-group variables.Results ① The sFlt1 levels of TNF-α + IFN-γ group were significantly higher than those of the control group at 24 h and 48 h (24 h (5.4±0.4) ng/ml vs (2.8±1.7) ng/ml,t=0.942,P=0.026;48 h (7.2±0.8) vs (4.3±1.0) ng/ml,t=4.285,P=0.005),while that at 72 h was not significantly different [(9.1±1.7) ng/ml vs (7.0±1.4) ng/ml,t=0.683,P=0.52].And no significant difference in sFlt1 levels between control group and TNF-α group or IFN-γ stimulation group were observed.② Compared with RA-FLSs,the expression of sFlt1 in HUCMSC was significantly higher (8.19±3.64) ng/ml vs (0.19±0.08) ng/ml,t=7.280,P＜0.01].After co-cultured with RA-FLSs and HUCMSC,the sFlt1 concentration of the co-culture group was significantly higher than that of HUCMSC group [(17.26±6.92) ng/ml vs (8.19±3.64) ng/ml,t=3.985,P=0.000 7].Conclusion The sFlt1 expression of HUCMSC is up-regulated by inflammatory cytokine TNF-α combined with IFN-γ.RA FLSs may promote the co-cultured HUCMSC to increase sFlt1 expression by secreting inflammatory factors.

Genioplasty with modified Mortise-Tenon joints technique / 中华医学美学美容杂志

Objective To explore a new modified stable genioplasty with modified MortiseTenon joints technique and to analyze the surgicaI results in clinic as well as to discuss the advantages in theory.Methods Eleven patients were performed by the genioplasty with Mortise-Tenon joints technique intraoral approach from June 2012 to March 2014,who were suffered from retrusion of chin with different degree accompanying with long chin.The two segments of the chin by osteotomy were made into the Mortise-Tenon joints and fixed by titanium plates.The results were evaluated by clinical appearances and image analyses.Results All 11 patients were satisfied with the procedure and the contour of the chin.The surgical effects were stable without any complications.The advancement in average Mortise-Tenon joints technique was 7.38 mm.Conclusions Much better in stablility and less relapse are achieved by using modified Mortise-Tenon joints technique;furthermore,the genioglossal muscle and geniohyoid muscle are reserved as much as possible,and therefore the normal function of them could be maintained.This method is a good alternative technique for chin retrusion coexisted withlong chin.

Mesenchymal stem cell alleviate primary biliary cirrhosis mice by down regulating autophagy of intrahepatic biliary epithelial cells via signal transducer and activator of transcription 3 / 中华风湿病学杂志

Objective To investigate the abnormality of intrahepatic biliary epithelial cells autophagy in primary biliary cirrhosis (PBC) mice,and explore the mechanism of UC-Mesenchymal stem cell (MSCs) in treating PBC.Methods After establishing the PBC model,we divided them into the PBC model group;the UC-MSCs treatment group and the Stattic group [Signal transducer and activator of transcription 3 (STAT3) inhibitor group].Six mice were used as the control group.Liver pathology and the serum pyruvate dehydrogenase complex E2 subunit (PDC-E2) antibody titers were detected.Autophagosome of the intrahepatic biliary epithelial cell was observed by electronic microscope.Protein levels of STAT3/pSTAT3,Beclin-1 were detected by western blot.We cultured human intrahepatic biliary epithelial cells in vitro,and down regulated STAT3.After stimulated by GCDC,we co-cultured them with UC-MSCs,and collected the cells in order to detect LC3 Ⅱ.The measurement data were compared with t test or single factor analysis of variance.Results Compared with the control group,periportal inflammatory cell infiltration and granuloma formation were observed in the PBC group.MSCs treatment decreased the infiltration of inflammatory cells.The level of antiPDC-E2 of the PBC group (107±18) ng/ml was higher than that of the control group (42±6) ng/ml (q=6.326,P＜0.01),MSCs treatment down regulated anti-PDC-E2 level (43±4) ng/ml (q=5.801,P＜0.01).More autophagosomes in the PBC group (5.00±1.29) than the control group (1.75±0.25) were observed (q=4.061,P＞0.05).Western blot showed that the level of Beclin-1 was higher in PBC group (1.80±0.36) than the control group (0.40±0.20) (q =6.757,P＜0.01),MSCs reduced the expression of Beclin-1 (0.86±0.06)(q=4.536,P＜0.05) as well as Stattic (0.72±0.03) (q=5.226,P＜0.05).PBC group had a higher expression level of STAT3 (1.80±0.42) (q=5.730,P＜0.05) and pSTAT3 (2.04±0.29)(q=6.492,P＜0.01) than the control group (0.50±0.05)(0.91±0.14).MSCs treatment decreased the expression of STAT3 (0.51±0.13)(q =5.703,P＜0.01) and pSTAT3 (0.76±0.07) (q =7.388,P＜0.01) in intrahepatic biliary epithelial cells.After down regulated STAT3 of HiBECs,MSCs reduced the expression of LC3 Ⅱ of HiBECs.Conclusion The intrahepatic biliary epithelial cells autophage of PBC mice is abnormal,MSCs can alleviate PBC by down regulating the autophage of intrahepatic biliary epithelial cells via STAT3.

Efficacy of distraction osteogenesis of mandible in adult patients with hemifacial deformity / 中华医学美学美容杂志

Objective To evaluate recurrence after mandibular distraction osteogenesis in adult patients with hemifacial microsomia using the digital three dimensional measurement.Methods Nine adult hemifacial microsomia patients were evaluated using the method of digital measurements with three dimensional computed tomography.Three observation points were studied:pre-operation (T0),post-operation (T1) and follow-up (T2).The length of ramus (H for normal side and h for affected side),the length of body (L for normal side and l for affected side) and distance between pogonion and facial midline (D) were measured and the recurrence rate (R) was calculated.Results Percentages of h/H at T0,T1,T2 were (58.19±12.06)％,(87.09±17.92)％and (81.13±30.57)％,which had statistical significance respectively.2.Percentage of l/L at T0,T1,T2 were (87.70±7.86)％,(90.69± 5.77) ％ and (90.11±5.62)％,respectively,which had statistical significance between T0 and T1.3.Lengths of D at T0,T1,T2 were (13.66±3.28) mm,(4.926±1.75) mm and (6.616±1.82) mm,respectively,which had statistical significance between T0,T1 and T0,T1.4.Average R was (22.80± 9.73) ％.Conclusions Varying degrees of recurrence do happen in both ramus and body of mandibular after distraction osteogenesis.While it is demonstrated that the mandible grows obviously after operation compared to that pre-operation,Meanwhile,the facial symmetry is also improved significiantly.

Influencing factors of health seeking intention among patients with type 2 diabetes in Chongqing Chronic Disease Management System / 复旦学报（医学版）

Objective To investigate the health seeking intention and its influencing factors among patients with type 2 diabetes in Chongqing Chronic Disease Management System.Methods Multistage cluster random sampling was used to investigate basic information,diabetes-related treatment situation including first heal seeking and reasons for choosing medical institutions in the last year.Relative risk ratios (RRR) and its influencing factors were analyzed with the method of multi-nominal Logistic regression,as community as a reference.Results Over the past year,38.02％ of type 2 diabetes patients preferred to hospitals above the county level,36.78％ preferred to pharmacy or clinics,and 25.21％ preferred to community health service centers.Univariate analysis showed that different education levels,family income levels,health insurance and therapies were significantly different from health seeking intention.Multi-nominal Logistic regression results indicated that higher educational level (RRR =2.39,95％ CI:1.20-4.78),higher income level (RRR =3.37,95％CI:1.44 -7.88),applying to specific diseases medical insurance (RRR =3.32,95 ％CI:1.72-6.42),the use of insulin and oral hypoglycemic agents (RRR =5.02,95％CI:1.15-22.00) of respondents were more inclined to the hospitals above the county level,rather than community health services.Conclusions Health seeking intention of type 2 diabetes patients preferred to hospital above the county level in Chongqing.Type 2 diabetes was an important disease of non-infectious chronic diseases,while the patients preferred go to utilize hospitals rather than community services.

Analysis with capability of responding to emerging infectious diseases among medical university students in Chongqing city / 重庆医学

Objective To take Ebola virus disease (EVD) as an example and analyze the capability of responding to emerging infectious diseases among medical university students in Chongqing city.Methods Medical university students of 2 094 in Chongqing were selected and investigated by cluster sampling.Questionnaire content includes social demographic information,knowledge,attitude,practice (KAP) and related factors about EVD.The variables of the respondents were described using mean and standard deviation for continuous variables and frequency distributions for categorical variables.Influencing factors were analyzed by using multiple-linear regression model.Results The average scores of KAP regarding EVD were 9.51 ±-3.97,5.93± 1.85,3.35 ±1.43,respectively.Multiple-linear regression analysis showed that the influencing factors of KAP regarding EVD were gender (x2 =0.773,P=0.000),residence (x2 =0.886,P=0.014) and health habits (x2 =0.316,P=0.008);gender (x2 =0.474,P=0.000),grade (x2 =0.118,P=0.024),residence (x2 =0.401,P=0.016) and health habits (x2 =0.307,P=0.000);gender (x2 =0.223,P=0.001),major (x2 =0.152,P=0.000) and health habits (x2 =0.231,P=0.000).Conclusion The capability of responding to emerging infectious diseases is not optimistic among medical university students.Medical universities should perform effective intervention according to the characters of different clusters.

Influencing factors of diabetic patients applying for specific disease health insurance and its treatment cost / 浙江大学学报·医学版

OBJECTIVE@#To compare the treatment costs on type 2 diabetes between patients with and without specific diseases health insurance, and to identify the influencing factors related to specific diseases health insurance application.@*METHODS@#A structured questionnaire was used to investigate basic information, diabetes-related pharmacy, outpatient and inpatient treatment costs. SAS9.1 software was used for statistical analysis. The enumeration data was analyzed by using Chi-square test, and variables of statistical difference were bought into Logistic regression model through stepwise method. Continuous variables were represented by median(inter-quartile range)[M(Q)], and were analyzed by using Wilcoxon test.@*RESULTS@#Compared with patients without specific disease health insurance in outpatient group, patients with specific disease health insurance had higher annual per capita total cost [2160(3081) vs 1000(2100) yuan, P5 years (OR=2.04) were more likely to succeed in specific diseases health insurance application.@*CONCLUSION@#To reduce the financial burden of patients with type 2 diabetes, government should make huge efforts to promote specific disease health insurance policies, and encourage patients to apply for it. Meanwhile, medical insurance department and medical institutions should reinforce supervision and simplify the application process. To improve the availability of specific disease health insurance, the number and coverage of designated retail pharmacies should be increased. Besides, government should pay more attention to low-income patients and those with short duration diabetes, so as to enhance their ability to resist economic risks and reflect the fairness of specific disease health insurance.