Proposal and thoughts on establishing and improving multi-level dental insurance in China / 中华口腔医学杂志

Oral diseases are highly prevalent in China, while oral health services are generally underutilized and public health resources are wasted. Lacking oral insurance may be one of the leading causes. The basic medical insurance of China does not cover dental care in most cities, which is worthy to further discuss. To better understand the experience of dental insurance from international dental care practice, the dental coverage scope, content, co-pay ratio, and effects of oral insurance on oral health improvement from the abroad countries with typical health insurance systems were summarized by using scoping review. Then, we discussed the coverage scope for dental health of basic medical insurance and private insurance in China. We also analyzed the current issues of dental care coverage and cost-share. At last, we proposed thoughts and suggestions to establish and improve a multi-level oral health insurance system with Chinese characteristics under the basic medical insurance frame. In particular, we gave suggestions on increasing the coverage for high dental care xpenditure by ebasic medical insurance, supplying children and teenagers with preventive dental care, and encouraging private insurance companies to cover dental care expenditure.

Clinical study on the treatment of rosacea with excessive heat in lung and stomach with self-made Liangxue-Qingfei Decoction combined with western medicine / 国际中医中药杂志

Objective:To evaluate the clinical efficacy of self-made Liangxue-Qingfei Decoction combined with conventional western medicine in the treatment of rosacea with excessive heat in lung and stomach. Methods:312 patients with rosacea in Longfu hospital from May 2017 to May 2019 were selected and randomly divided into two groups, 156 cases in each group. The control group was treated with Doxycyclane Hyclate Tablets combined with Metronidazole Gel The study group was additionally given self-made Liangxue-Qingfei Decoction on the basis of the control group. Both groups were treated for 4 weeks. Dermatology Life Quality Index (DLQI) was evaluated . The erythema index (EI) of lesion area was measured by multi-functional skin tester. The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total effective rate was 80.8% (126/156) in the study group and 66.7% (104/156) in the control group, with statistically significance ( χ2=8.012, P=0.005). After the treatment, the scores of physiology, psychology, family, social activities, interpersonal and occupational restrictionsin, and treatment in the study group were lower than those in the control group ( t=17.942, 15.794, 19.465, 21.586, 31.375, 27.472, P<0.001); EI (619.69 ± 71.53 vs. 822.97 ± 89.47, t=32.348) was lower than that of the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 4.5% (7/156) in the control group and 5.8% (9/156) in the study group, and there was no significant difference between the two groups ( χ2=0.439, P=0.514). Conclusion:The self-made Liangxue-Qingfei Decoction combined with routine western medicine therapy can effectively improve the clinical symptoms and quality of life of rosacea patients with lung and stomach excessive heat, improve the clinical efficacy with safety.

Evaluation of therapeutic effect and health economics of general anesthesia and routine outpatient dental treatment in children with severe early child caries / 华西口腔医学杂志

OBJECTIVES@#To evaluate the efficacy and health economics of the comprehensive therapy for the children with severe early child caries (S-ECC) under dental general anesthesia (DGA) and conventional outpatient treatment to provide references for dentists and parents in the choice of clinical treatment.@*METHODS@#A retrospective cohort study was conducted on S-ECC children aged 36-71 months and who received dental treatment under general anesthesia or routine outpatient situation. The filled tooth survival rate, treatment cost, and cost-filled tooth survival time of the two groups were compared, and the curative effect and health economics was evaluated.@*RESULTS@#The filled tooth survival rate of the DGA group was higher than that of the routine outpatient group (@*CONCLUSIONS@#Compared with the conventional outpatient treatment group, the treatment outcomes of S-ECC under general anesthesia were better, and the costs were higher. However, no significant difference was observed in the total medical cost-filled tooth survival time between these two groups, and the conventional outpatient treatment did not have evident economic advantages.

Psychological intervention in oral patients in novel coronavirus pneumonia outbreak period / 中华口腔医学杂志

Public health emergencies have an impact on the public mental health. The outbreak of the novel coronavirus has affected the normal diagnosis and treatment services in oral medical institutions across the country. Delay of non-emergency dental service will have a potential impact on the experience, cognition, treatment and rehabilitation of patients with oral diseases. Through literature review, this paper reviewed the oral psychosomatic diseases closely related to patients' psychological state, such as oral mucosal disease, temporomandibular joint disease, bruxism, periodontal disease and so on. It was believed that these patients might be more susceptible to the impact of stress events, and dental specialists should pay more attention to them. At the same time, this paper analyzes the possible psychological stress symptoms of patients with different oral diseases, and puts forward suggestions for remote consultation and emergency treatment of dentists. From the perspective of social role, dentists not only played the role of expert in dental home professional guidance, but also played the role of psychological counseling for patients.

Comparison of the stability of direct anterior approach versus posterolateral approach in minimallyinvasive total hip arthroplasty / 中国组织工程研究

BACKGROUND: At present, minimally invasive total hip arthroplasty is gradually developed, and becomes one of the representative types of total hip arthroplasty. The direct anterior approach is characterized by small tissue injury, low postoperative complications and rapid postoperative recovery. Compared with other approaches, there is still a lot of controversy on whether the approach can obtain better early and long-term effects. OBJECTIVE: To compare the clinical effect of direct anterior approach and posterolateral approach in minimally invasive total hip arthroplasty. METHODS: Totally 88 patients with minimally invasive total hip arthroplasty from September 2015 to September 2016 in the First Department of Orthopedics, Changzhou City Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine were selected as the subjects. The patients were divided into direct anterior approach group and posterolateral approach group, with 44 patients in each group. The incision length, operation time, postoperative drainage volume, blood transfusion volume, hemoglobin difference before and after operation, time of bed walking, postoperative acetabular abduction angle and acetabular anteversion angle were recorded and compared. Blood sedimentation rate, C-reactive protein levels, complications (infection, vascular injury and hip dislocation), hip function Harris score preoperatively, postoperatively 1, 3, and 6 months were analyzed. RESULTS AND CONCLUSION: (1) There was no significant difference in the postoperative acetabular abduction angle and acetabular anteversion angle between both groups (P > 0.05). (2) The average operation time of the patients in the direct anterior approach group was significantly longer than that in the posterolateral approach group (P < 0.05). The length of incision, intraoperative blood loss, postoperative drainage volume, hemoglobin difference, postoperative erythrocyte sedimentation rate, postoperative C-reactive protein and time of bed walking were significantly lower in direct anterior approach group than in posterolateral approach group (P < 0.05). (3) Harris score of direct anterior approach group was significantly higher than that of posterolateral approach group (P < 0.05). There was no significant difference in Harris score between the two groups before and 6 months after operation (P > 0.05). (4) There was no significant difference in postoperative complications between the two groups (P > 0.05). (5) There is no significant difference in the efficacy during 6-month follow-up and postoperative complications between posterolateral approach and direct anterior approach, but the direct anterior approach is less traumatic, with faster postoperative recovery, higher joint stability, more consistent with minimally invasive surgery and the concept of rapid rehabilitation.

Dental care utilization of immigrants in Chengdu, China / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study considered Chengdu, Sichuan, China as an example to investigate the dental service utilization by foreigners and its influencing factors. Results of the study can be referred by dental practitioners to explore international development of dental services and can be provided for health policy makers to formulate oral health policies for immigrants.</p><p><b>METHODS</b>A simple random sampling method with a questionnaire was designed based on Anderson's health utilization model and "Oral Health Questionnaire for Adults" by the World Health Organization. Oral health condition, consciousness, and demographic data were collected. Binary Logistic regression and stratified analysis with SPSS 20.0 were performed.</p><p><b>RESULTS</b>A total of 654 immigrants repre-senting 75 countries participated in the study. Among all participants, 102 (15.6%) experienced dental problems while in residence in China but paid no visit to dentists. Female immigrants, who spent considerable time living in Chengdu, experienced oral problems in a year, used dental floss, and reported family members in Chengdu, were more likely to visit Chinese dentists. Participants who lived in Chengdu for at least 10.5 months were the threshold distinguishing differences in dental visits in the country.</p><p><b>CONCLUSIONS</b>The policymakers in Chengdu should consider creating a convenient and conducive dental care environment for immigrants. Additional information related to urgent oral and routine care should be provided to short- and long-term living immigrants in China. Dental practitioners in China should also contemplate on collaborating with foreign dental insurance companies to ensure better dental care access for immigrant patients.</p>

Factors influencing oral insurance among children in Chengdu / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aimed to investigate the value of child oral health for Chengdu parents, their intentions, and factors influencing their decision to acquire oral insurance coverage for their childrens.</p><p><b>METHODS</b>A total of 562 Chengdu parents were interviewed using questionnaires by convenient sampling, and the results were analyzed using SPSS 20.0.</p><p><b>RESULTS</b>The age of children (B = -1.741, P = 0.004), age of parents (B = 2.031, P = 0.003), level of oral discomfort (B = 0.569, P = 0.000), incurring/not incurring oral care expenses in the previous year (B = 1.897, P = 0.014), the last time parents' had teeth cleaned (B = 0.777, P = 0.006), and acquiring/not acquiring commercial insurance coverage (B = 1.632, P = 0.031) significantly influenced the intention of acquiring child oral insurance.</p><p><b>CONCLUSION</b>Child oral health, health and insurance awareness of parents, and other factors influenced the intention of parents to purchase oral insurance coverage for their children, which were significant to establish pediatric dental insurance.</p>

Impact of 36-hour sleep deprivation on visuo-motor coupling mechanism in young soldiers / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the impact of 36-hour sleep deprivation (SD) on the brain electrophysiological indicators of visuo-motor coupling in young soldiers.</p><p><b>METHODS</b>During the 36-hour SD, 10 healthy young soldiers were tested on visuospatial rotation tasks by event-related potentials system before and after SD. The incubation period and amplitude of P500 as well as their error number and reaction time were measured.</p><p><b>RESULTS</b>Compared with subjects in SD 0-hour,subjects in SD 36-hour had significantly increased error rate [(9.7 ± 3.9)% vs. (18.3 ± 4.5)%, P<0.05] and significantly increased reaction time [(632.5 ± 53.6) ms vs. (693.6 ± 65.7) ms, P < 0.05]. Subjects in SD 36-hour showed significantly reduced amplitudes than those in SD 0-hour [(8.7 ± 2.3) ΜV vs. (5.2 ± 1.6) ΜV, P < 0.05]. Additionally, subjects in SD 36-hour showed significantly increased P500 latencies than did those in SD 0-hour [(489.6 ± 42.6) ms vs .(530.2 ± 51.9) ms, P < 0.05]. Compared with subjects in SD 0-hour, the deficit was an absence of a mental rotation function SD 36-hour in subjects.</p><p><b>CONCLUSIONS</b>The 36-hour SD in young soldiers can harm the processing mechanism of visuo-motor coupling in a certain extent. SD can affect the fixed position ability of visual space cognition in young soldiers.</p>

A pilot study on spinal muscular atrophy carrier screening in Shanghai region using real-time PCR / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To develop a screening program for spinal muscular atrophy (SMA) carriers, and to assess the carrier frequency and detection rate in Shanghai region.</p><p><b>METHODS</b>Quantitative analysis of the SMN1 gene by real-time PCR was developed using specimens from 15 SMA patients and 76 SMA parents from 38 affected nuclear families. A pilot screening was carried out for 1741 asymptomatic pregnant women. Frequencies of SMN1 alleles were determined with the Hardy-Weinberg equilibrium.</p><p><b>RESULTS</b>Forty five out of the 1741 women were identified as SMA carriers by the presence of single copy of SMN1. The frequencies of no copy, 1 copy, 2 copy and 3 copy alleles were 1.37 U+00D7 10-2, 9.45 U+00D7 10-1, 2.80 U+00D7 10-2 and 1.27 U+00D7 10-2, respectively. The adjusted SMA carrier frequency was 1:35 with a detection rate of 94.49%. For those with a negative screening result, individuals with 3 copies carried a higher residual risk.</p><p><b>CONCLUSION</b>The incidence of SMA carriers in Shanghai region is similar with that in Caucasian populations. Carrier screening has high detection efficiency. An effort should be made to further distinguish SMN1 gene copy numbers for those with more than 2 copies, since accurate determination of 2 and 3 copy allele frequencies is essential for post-screening genetic consulting.</p>

Analysis of the development of dental insurance in China / 华西口腔医学杂志

This article explained the character of dental disease and effective facts for dental health utilization, and current situation of basic medical insurance for oral diseases through checking up relative articles. Dental insurance had a positive effect on utilization of dental medical service and public oral health. The PEST tool was used to analyze the environment of dental insurance developing direction and feasibility in this article, and then raise some suggestions and core strategies for developing dental insurance. We believe that the dental insurance can increase the oral health service utilizations and enhance the oral health for Chinese people. Only oral insurance will be developed, Chinese oral health could be geared to international practice.

Therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiotherapy / 西安交通大学学报·英文版

Objective: To assess the therapeutic efficiency of short anterior urethral stricture treated with endourethral surgery combined with iridium 192 radiation therapy in order to decrease the recurrence rate after endourethral surgery. Methods: A total of 286 patients with anterior urethral stricture (stricture length ranging from 0.5 to 2.5 cm, averaging at 1.6 cm) were divided randomly into two groups after internal urethrotomy and cicatrix electrotomy. The radiation group of 173 patients was treated as soon as possible with iridium 192 radiation therapy on the stricture sections while the control group of 113 patients was not. The recurrence rate was compared between the two groups during one year's follow-up. Results: Among all the 286 successful operations, stricture recurred in 19 patients of the radiation group (recurrence rate of 10.98%) and in 62 ones of the control group (recurrence rate of 54.86%), with a significant difference (P=0.003). Conclusion: It is an effective way to prevent recurrence by treating patients as early as possible with iridium 192 radiation on the stricture sections after endourethral operation on anterior urethral stricture.

Clinical and experimental study on effect of qinbal ointment in treating psoriasis in the active stage of blood-heat syndrome type / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate and compare the efficacy and safety of two kinds of Qinbai ointment prepared conventionally and finely (C-QBO and F-QBO) in treating psoriasis in the active stage of blood-heat syndrome type, and to observe their influences on vaginal epithelial cell mitosis, also on keratinization of caudal flakes in mice.</p><p><b></b>METHODS</p><p><b>CLINICAL OBSERVATION</b>Adopting randomized, single-blinded, controlled design, 93 patients administered orally with Liangxue Huoxue Decoction were randomized into three groups treated externally with C-QBO, F-QBO and white vaseline respectively, applied twice a day for 8 weeks. The safety was checked and the changes of modified psoriasis area severity index (PASI), as well as the conditions of skin lesions (size, erythema, infiltration, squama, and itching) and symptom improving time were compared. Experimental study 1: Mice were randomized into the model group, the C-QBO group, the F-QBO group and the blank group, 7 in each group. Their vaginal epithelial cell mitosis indices were compared after 3 days of treatment with corresponding remedies. Experimental study 2: Mice were randomized into the C-QBO group, the F-QBO group and the blank group, 7 in each group. After the mice had been treated with corresponding remedies for 28 days, the granular layer formation in their caudal scales was compared.</p><p><b></b>RESULTS</p><p><b>CLINICAL OBSERVATION</b>The markedly effective rate was 63.3% (25/30) in the C-QBO group, 66.7% (20/30) in the F-QBO group, and 36.7% (11/30) in the control group. No statistical difference was showen between the two QBO treated groups (P > 0.05), but that in both of them was significantly different from that in the control group (P < 0.05). PASI scores lowered after treatment in all the three groups (P < 0.01), but the improvement in the two QBO groups was better than that in the control group (P < 0.05); the conditions of skin lesion were improved in all groups, but the improvements were more significant in the two QBO groups in terms of squama, infiltration and itching (P < 0.05), in aspects of improving time on erythema, infiltration and itching, especially the itching, F-QBO was superior to the C-QBO. Experimental study 1: The mitosis index in both QBO groups was lower than that in the blank group and the model group (P < 0.01). Experimental study 2: Number of scales with granular layer formation was higher in the two QBO groups than in the blank group (P < 0.01).</p><p><b>CONCLUSION</b>C-QBO and F-QBO can effectively relieve the skin lesion of psoriasis patients in the active stage of blood-heat type, and they could also promote the formation of epithelial granular layer in the caudal scales of mice.</p>

Total hip surface replacement arthroplasty: report of 31 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To introduce the technique of total hip surface replacement, evaluate the early results and review the factors which affect the results.</p><p><b>METHODS</b>From October 2000 to January 2005, 31 patients (37 hips) with osteonecrosis, osteoarthritis, hip dysplasia, ankylosing spondylitis were treated with the total hip surface replacement. Among them, 15 were male, and 16 were female, with an average age of 42 years (range from 23 - 65 years). All the 31 patients had the indications for hip surface replacement. Standard operation technique which was brought forth by Amstutz and Nelson was employed, and all patients were followed up after operation.</p><p><b>RESULTS</b>Patients were followed up for an average period of 42 months (3 - 51 months). There were no femoral neck fracture, no dislocation, no infection in all patients. Radiolucent line existed around acetabular prosthesis in 1 hip and another hip had been revised because the prosthesis of femoral head was in incorrect situation. The average Harris hip score improved significantly from 30 to 90, and the score was 93 in the latest follow-up. Based on Harris system, 35 hips were excellent, 1 hip good, and 1 hip fail.</p><p><b>CONCLUSIONS</b>The total hip surface replacement is an effective solution for the problem of the patients with osteonecrosis of the femoral head, osteoarthritis, hip dysplasia and ankylosing spondylitis. The short-term results are satisfied.</p>

Experimental Study of Three Kinds of Chinese Herbs in Treating Psoriasis / 中国中医药信息杂志

Objective To study the mechanism of the extract of three kinds of Chinese herbs in treating psoriasis.Methods Three kinds of Chinese herbs(coptis root,patience dock root and atratylodes rhizome) were extracted.With the culture of human transformed keratinocyte cell line colo-16 cells as a model,the single and compound effects on the growth of KC were studied before and after stimulated by TNF-?.Results The single and compound extract of three Chinese herbs could restrain the proliferation of KC before and after stimulated by TNF-?.The effect was more remarkable than the compared methotrexate and cyclosporin A(P

Adenosine-5'-triphosphate test for the noninvasive diagnosis of AV nodal dual pathways(AVNDP) and assessment of results of slow pathway ablation in patients with AV nodal reentrant tachycardia / 中国临床药理学与治疗学

Aim To assess the value of the administration of adenosine-5'-triphosphate (ATP) during sinus rhythm for noninvasive diagnosis of AV node dual pathways(AVNDP) and abolition or modification of the slow pathway (SP) after radiofrequency(RFCA) in patients with inducible sustained AVNRT. Methods Incremental doses of ATP were intravenously administrated during sinus rhythm to patients with spontaneous or inducible sustained AVNRT(study group, n=45)and to patients with no evidence of AVNDP or inducible AVNRT (control group, n=37) until ECG signs of AVNDP( 50 ms increase or decrease in P-R interval in two consecutive beats, or occurrence of AVNRT) or second-degree AV block were observed. Results Four patients (two in study patients and two in control patients) could not complete the trial and were excluded from analysis. AVNDP was observed by ATP in 36(84%) study patients, whereas it was diagnosed by electrophysiology criteria in 38(88%) patients. AVNDP was observed only in 1(3%) control patient. AVNDP by ATP test was disappeared in 18(90%) of 20 patients who underwent SP abolition and in 3(38%) of 8 patients who underwent SP modification. Conclusion ATP test during sinus rhythm enables noninvasive diagnosis of AVNDP in a high percentage of patients with inducible AVNRT and reliably confirms the results of RFCA of the SP.

Study on the Rule of Distribution of TCM Syndromes of Psoriasis / 中医杂志

Objective To discuss the rule of distribution of TCM syndromes of Psoriasis (Ps).Methods The 205 Ps vulgaris outpatients were investigated and the case research forms were filled in.Based on the diagnosis standard of TCM syndromes,the patients were differentiated into different syndromes.The correlation between the syndromes and clinical materials were discussed.Results The main TCM syndromes of Ps were blood heat,blood stasis,blood dryness,blood heat-stasis,blood heat-dryness and blood stasis-dryness.The distribution of these six main syndromes in different ages,disease stages,and recurrent time in different groups was significantly different (P