Do medical alliances truly work? Perspectives on health service utilisation among outpatients with chronic diseases in Shanghai, China.

Background: To achieve proper health utilisation among various health institutions and improve primary care capacity, China implemented medical alliance (MA) reform as part of healthcare reforms in 2009. With chronic disease management as the focus and priority of primary health institutions, this study aimed to analyse the specific distribution and trends of outpatient visits to various levels of health institutions (community health centres (CHCs) vs hospitals) in MAs.

Methods: All outpatient data were extracted from the Chuansha MA in Pudong New Area, Shanghai, between 2016 and 2020, and submitted to descriptive analysis, Chi-Square tests and correlation analysis.

Acetoacetate Improves Memory in Alzheimer's Mice via Promoting Brain-Derived Neurotrophic Factor and Inhibiting Inflammation.

The ketone bodies, especially the β-hydroxybutyrate, had been shown to modulate the function of the central nervous system and prevent the pathological progression of Alzheimer's disease (AD). However, little is known about the role of acetoacetate in the AD brain. Thus, we intraventricularly injected acetoacetate into familial AD mice (APPSWE) for 14 days and monitored their memory and biochemical changes.

Invention of a non-invasive intracranial pressure (ICP) monitoring system - an enlightenment from a hydrocephalus study.

Background: Mechanical obstruction is the most common cause of shunt failure for hydrocephalic patients. However, the diagnosis is extremely challenging and often requires invasive testing methods. Thus, a simple and non-invasive technique is in urgent need to predict the intracranial pressure (ICP) of hydrocephalic patients during their post-surgical follow-up, which could help neurosurgeons to determine the conditions of the shunt system.

Introduction of a Novel, Continuous, Noninvasive Estimation of Intracranial Pressure and Cerebral Perfusion Pressure Based on Tympanic Membrane Temperature.

Objective: Hydrocephalus is a common but potentially life-threatening condition. However, valve malfunction makes further diagnosis difficult. Thus, we tried to develop a noninvasive method to detect the hydrocephalus intracranial pressure (ICP) during routine follow-up.

Facilitate Signing with the Family Doctor: A Study of the Practice in Shanghai, China.

Background: In the time since primary care was implemented in China in 2009, programs of promoting residents signing with family doctor services have been key. However, there has been a lack of effective evaluation of its implementation.

Methods: We used mixed methods for evaluating existing measures of facilitating signing with family doctors in Shanghai.

Role of Peroxisome Proliferator-Activated Receptors (PPARs) in Trophoblast Functions.

Peroxisome proliferator-activated receptors (PPARα, PPAR, and PPAR) belong to the transcription factor family, and they are highly expressed in all types of trophoblast during pregnancy. The present review discusses currently published papers that are related to the regulation of PPARs via lipid metabolism, glucose metabolism, and amino acid metabolism to affect trophoblast physiological conditions, including differentiation, maturation, secretion, fusion, proliferation, migration, and invasion. Recent pieces of evidence have proven that the dysfunctions of PPARs in trophoblast lead to several related pregnancy diseases such as recurrent miscarriage, preeclampsia, intrauterine growth restriction, and gestational diabetes mellitus.

Expression of trophoblast derived prostaglandin E2 receptor 2 (EP2) is reduced in patients with recurrent miscarriage and EP2 regulates cell proliferation and expression of inflammatory cytokines.

Backgroud: Prostaglandin E2 (PGE2), an inflammatory mediator, modulates cytokines, regulates immune responses in reproductive processes and stimulates inflammatory reactions via the prostaglandin E2 receptor 2 (EP2). However, the regulatory effects of EP2 signaling on trophoblasts and its role in unexplained recurrent miscarriage (uRM) remains unclear.

Patients And Methods: A total of 19 placentas from patients with a history of more than two consecutive pregnancy losses of unknown cause (uRM group) and placentas of 19 healthy patients following a legal termination of their pregnancy were used for PGE2 receptor (EP1, EP2 and EP4) expression analyses via immunohistochemistry.

Effect of ambient air pollutants and meteorological variables on COVID-19 incidence.

Objective: To determine whether ambient air pollutants and meteorological variables are associated with daily COVID-19 incidence.

Design: A retrospective cohort from January 25 to February 29, 2020.

Setting: Cities of Wuhan, Xiaogan, and Huanggang, China.

Three-dimensional Contrast-enhanced Ultrasound in Response Assessment for Breast Cancer: A Comparison with Dynamic Contrast-enhanced Magnetic Resonance Imaging and Pathology.

To compare the capabilities of three-dimensional contrast enhanced ultrasound (3D-CEUS) and dynamic contrast-enhanced magnetic resonance (DCE-MRI) in predicting the response to neoadjuvant chemotherapy (NAC) among breast cancer patients, 48 patients with unilateral breast cancer were recruited for 3D-CEUS and DCE-MRI examinations both before and after NAC; pathology was used to validate the results. This study was approved by the institutional review board, and written informed consent was obtained from each patient. Imaging feature changes and pathological vascularity response, including microvessel density (MVD) and vascular endothelial growth factor (VEGF), were calculated.

Imaging of Scrub Typhus by PET/CT.

A 19-year-old man had an unexplained fever, dizziness, headache, fatigue, and pain in the scrotum. An FDG PET/CT imaging was acquired to assess fever of unknown origin. The images showed multiple foci of increased FDG activity in the enlarged lymph nodes in the body.

Cystic breast lesions by conventional ultrasonography: sonographic subtype-pathologic correlation and BI-RADS Assessment.

Introduction: Appropriate categorization is very important because the clinical management of each subtype of cystic breast lesions (CBLs) differs. The purpose was to evaluate the sonographic subtype-pathologic correlation, and to identify the effectiveness of the Breast Imaging Reporting and Data System (BI-RADS)-ultrasound (US) for differentiation of benign and malignant CBLs.

Material And Methods: A database from December 1, 2007 and November 30, 2009 was identified in the Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, China.