The Impact of China's Family Floating Population on the Participation of Medical Insurance in the Inflow Areas.

Background: With the transformation of China's economy and society, the floating population has also shown a new development trend, from individual migration to co-migration with family members. In 2020, among the 376 million floating population, the population flowing to cities and towns was 330 million, accounting for nearly 88.1%. The family mobility of the floating population is not just a simple personal gathering or geographical migration, but a profound adjustment of the living environment, social interaction and the interests of family members. Migrants no longer simply play the role of " urban passers-by", but gradually move with spouses, children, parents, and even settle in the city, which will inevitably produce different public service and social security needs. Objective: To explore the impact of floating population's familyization on the participation of medical insurance in the inflow areas. Methods: This study adopted the form of non-systematic literature review. The key words were floating population and medical insurance. The related analysis of PubMed, Embase, CNKI, Wanfang, and VIP databases were reviewed and summarized. Results: Due to the flow between domestic immigrants and regions, their medical insurance is difficult to be guaranteed. The domestic floating population's demand for health services is increasing, but the coverage of medical services provided by medical insurance is not comprehensive enough. Conclusion: It is necessary to integrate the medical insurance system and improve the adaptability of medical insurance to family mobility; protect the welfare needs of migrant families and increase their willingness to participate in medical insurance at the destination; pay attention to the interaction and integration of floating population families, understand and guide them to participate in the status quo of medical insurance, and improve the status quo.

Bifunctional Lewis Base Catalyzed Asymmetric N-Allylic Alkylation of 2-Hydroxypyridines.

A chiral Lewis base catalyzed enantioselective N-allylic alkylation of 2-hydroxypyridines and MBH carbonates is documented, affording a convenient access to N-alkylated 2-pyridones with up to 99% ee and 99% yield. Experimental and computational studies have revealed that the strong hydrogen bond interaction between the chiral Lewis base catalyst and 2-hydroxypyridines plays a crucial role in this reaction for the reactivity, chemoselectivity, and enantioselectivity.

Grade G2 Rectal Neuroendocrine Tumor Is Much More Invasive Compared With G1 Tumor.

BACKGROUND: To compare clinicopathologic feature of rectal neuroendocrine tumor (NET) grade G1 with G2 NET. METHODS: Six hundred-one cases of rectal G1 and G2 NETs diagnosed in our center were analyzed. RESULTS: Of 601 cases of rectal NET, 515 cases were with grade G1 and 86 cases were with grade G2. Median tumor size was 0.7 cm. Compared with G1 NET, G2 tumors were with significantly larger tumor size (0.8 vs 2.2 cm, p < 0.001), less percentages of patients with tumors confined to submucosa (92.6 vs 42.8%, p < 0.001), more frequent presence of microvascular invasion (MVI) (3.6 vs 16.9%, p < 0.001) or peri-neural invasion (PNI) (2.0 vs 24.1%, p < 0.001). Incidence of lymph node and distant metastasis was 5.2 and 2.1% in G1 NET compared with 44.2 and 31.4% in G2 tumor, respectively (p < 0.001). For tumors sized 1-2 cm and confined to submucosa, incidence of lymph node metastasis was 6.1% for G1 NET compared with 21.1% for G2 NET. Status of MVI/PNI was predictive of lymph node metastasis for G2 tumor rather than G1 NET in this subgroup. CONCLUSIONS: Rectal G2 NET was much more invasive with significantly elevated prevalence of lymph node metastasis compared with G1 tumor.

Immunosuppressive effect of IDO on T cells in patients with chronic hepatitis B*.

AIM: Recently indoleamine 2,3-dioxygenase (IDO) has drawn considerable attention as a mechanism of immune regulation. Our study was to observe the role of IDO in immune tolerance of chronic hepatitis B (CHB), so as to provide a novel approach for reestablishment of active immunity. METHODS: Peripheral venous blood samples were taken from 50 CHB patients and HBV viral load, T lymphocyte subsets as well as the mRNA, protein and activity of IDO were detected. The correlations between HBV viral load, T lymphocyte subsets and IDO were statistically analyzed. Blood samples from 50 healthy people were tested as a control group. RESULTS: In CHB patients, the mRNA, protein and activity of IDO were all significantly more than those in control group (mRNA:[2.11 +/- 0.615] x 10(3) vs. [0.143 +/- 0.026] x 10(3); protein: 0.22 +/- 0.06 vs. 0.02 +/- 0.0017; activity: 26.07 +/- 8.12 vs. 4.98 +/- 1.65; P < 0.05) and IDO mRNA was positively correlated with HBV viral load (r = 0.502, P < 0.001) and alanine aminotransferase (ALT) (r = 0.65, P < 0.01). Furthermore, IDO mRNA, protein and activity were negatively correlated with CD4(+) T cells (r = -0.622, -0.682, -0.549 respectively, P < 0.05), CD8 (+) T cells (r = -0.487, -367, -294 respectively, P < 0.05) and the ratio of CD4/CD8 (r = -0.426, -0.533, -0.397 respectively, P < 0.05). CONCLUSION: IDO closely correlates with HBV viral load and is responsible for immunotolerance against HBV. Suppression of IDO could be a novel approach to break tolerance in CHB.

Probe-based confocal laser endomicroscopy for the diagnosis of undetermined biliary stenoses: A meta-analysis.

BACKGROUND: Presently, both the accuracy and sensitivity for distinguishing biliary stenosis from benign to malignant are low. In recent articles, the probe-based confocal laser endomicroscopy (pCLE) showed a better sensitivity than traditional methods in diagnosing malignant biliary stenosis. Here, we conducted a meta-analysis to summarise the published literature. METHODS: A systematic search for literature was conducted in the Medline, Embase and Cochrane Library databases published until November 2015. Further publications were found in the reference lists of the relevant articles. A quality assessment and data extraction were performed by two reviewers independently. A meta-analysis was performed to evaluate the diagnostic efficiency of a pCLE for discriminating benign and malignant biliary stenoses. RESULTS: Eight studies involving 280 patients were included in the analysis. Significant heterogeneity in specificity was observed among the studies (Cochran's Q test=15.89, degrees of freedom [df]=7, P=0.0261 and I2=55.9%), while the heterogeneity in sensitivity was not obvious (Cochran's Q test=7.99, df=7, P=0.3334 and I2=12.4%). The area under the summary receiver operating characteristic (SROC) curve was 0.8968. The meta-regression and subgroup analysis indicated that the outlier was the source of heterogeneity. When analysed in the random-effects model, the pooled sensitivity, specificity, positive likelihood ratio (LR) and negative LR were 0.90 (0.84-0.94), 0.75 (0.66-0.83), 3.17 (2.18-4.61) and 0.17 (0.11-0.26), respectively. No significant publication bias was found in our research. CONCLUSION: A pCLE is a valuable method for the differential diagnosis between malignant and benign biliary stenoses. However, a preferable diagnostic standard should be explored and improvements in specificity are required.

[Immunosuppressive effect of indoleamine 2, 3-dioxygenase on T cells in patients with chronic hepatitis B].

OBJECTIVE: To investigate the role of indoleamine 2,3-dioxygenase (IDO) in immune tolerance in patients with chronic hepatitis B (CHB). METHODS: Peripheral venous blood samples were collected from 50 CHB patients, and HBV viral load, T lymphocyte subsets and of IDO mRNA, protein and activity were detected with the blood samples from 50 healthy donors as the control. The correlations between HBV viral load, T lymphocyte subsets and IDO were statistically analyzed. RESULTS: In CHB patients, the mRNA and protein levels and activity of IDO were all significantly higher than those in control group [mRNA: (2.110-/+0.615)x10(3) vs (0.143-/+0.026)x10(3); protein: 0.22-/+0.06 vs 0.02-/+0.0017; activity: 26.07-/+8.12 vs 4.98-/+1.65; P<0.05]. IDO mRNA level was positively correlated to HBV viral load (r=0.502, P<0.001) and ALT (r=0.65, P<0.01), and IDO mRNA, protein and activity were inversely correlated to CD4+ T cells (r=-0.622, -0.682, and -0.549, respectively, P<0.05), CD8+ T cells (r=-0.487, -367, and -294, respectively, P<0.05) and the ratio of CD4/CD8 (r=-0.426, -0.533, and -0.397, respectively, P<0.05). CONCLUSION: IDO is closely correlated to HBV viral load and responsible for immunotolerance against HBV. Suppression of IDO can be a new therapeutic approach to reverse immunotolerance in CHB.