The present paper presents the design of a remote monitoring system based on smartphone and mobile internet. The system can realize functions such as multi-physiological parameter collection, micromation of collecting equipment, real-time monitoring, remote data transmission, automatic alarm, physiological parameter analyze and Global Position System (GPS) location of patient's position. Besides acting as a receiver and transmission platform, smartphone can also process and analyze the physiological parameters, such as detection of the apnea from electrocardiogram (ECG). The system contains technologies of MCU, Bluetooth transmission, Android and Wed development, wavelet transform, mobile communication as a whole. It propels further developments of the remote mobile medical based on smartphone.
Cell Phone ; Electrocardiography ; Geographic Information Systems ; Humans ; Internet ; Monitoring, Ambulatory

Objective To detect the expression of stem-cell related factors Nanog and CD44 in spheroid body-form?ing cells of gastric cancer cell line MKN-45. Methods The gastric cancer cell line MKN-45 was used to culture spheroid bodies in non-adherent condition in a serum-free medium supplemented with epidermal growth factor (EGF) and basic fibro?blast growth factor (bFGF). Using Western blot analysis, immunofluorescence staining and quantitative real time polymerase chain reaction(qRT-PCR), the expression levels of stem cell-related genes Nanog and CD44 were studied. Results In this study, we observed that MKN45 cells formed spheroid bodies in non-adherent condition in a serum-free medium, and the levels of Nanog and CD44 mRNA expression in spheroid body-forming cells were 2.34 ± 0.22 and 1.18 ± 0.04,respectively, which were higher than those in parental cells (1.00±0.00 and 1.00±0.05). The levels of Nanog and CD44 protein expression in spheroid body-forming cells were 0.18±0.02 and 0.24±0.04, respectively, which were significantly higher than those in pa?rental cells (0.07±0.02 and 0.18±0.01, P<0.05). Nanog protein was positively stained within the perinuclear and cytoplasm of the spheroid body-forming cells, and CD44 was positively stained mainly in the membrane. Dual staining of Nanog/CD44 indicated that the embryonal protein Nanog was co-localized with CD44 in the spheroid body-forming cells. Conclusion Spheroid body-forming cells developed from human gastric cancer cell line MKN-45 in serum-free medium supplemented with EGF and bFGF show characteristics of cancer stem cell (CSC). The cells co-expressed of CD44 and Nanog maybe a phe?notype of gastric CSCs.

Objective To establish reference intervals of nine laboratory projects for hepatorenal function and verify its reliability by indirect method . Methods ALL test results were extracted from physical examinations that were stored in the laboratory information system of Zhongshan Hospital during 2012 to 2014.Using Skewness-Kurtosis test to detect the normality of data , if not the original data were transformed through BOX-COX transformation to obtain an approximatenormal distribution .Outliers were identified and omitted by Turkey method .The indirect reference intervals were taken by applying Hoffmann method.The reference change value ( RCV) was selected to inspect the statistical significance between the calculated and published reference intervals .Results Among those nine laboratory projects ,thedifferences betweenthereference intervalsfor ALT , AST, AKP, GGT, TP, BUNwerelessthan their RCV ( <60.12%, 38.12%, 19.9%, 41.53%, 8.53%, 37.5%) , there were no significant differences between the direct method.There were slight differences between the calculated reference intervals and published reference intervals for the lower limit of the LDH and the upper limit of the ALB (>26.65%,9.92%) ,and there was a significant difference between the calculated reference intervals and the current reference interval in the laboratory for the lower limit of the UA of male (>26.65%).Conclusion This research further proved the reliability of indirect reference intervals and this technique deserved to be promoted and applied by other clinical laboratories.

Objective To evaluate the impact of aderent perirenal fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN). Methods Clinical data of 52 patients who underwent RLPN for a small renal tumor from October 2013 to December 2015 was analyzed retrospectively. All the patients were divided into two groups according to the presence of APF by preoperative computed tomography imaging. Clinical data was collected including patients' age, gender, BMI, history of hypertension, history of diabetes, American Society of Anesthesiologists score (ASA), intra-abdominal fat (IAF), tumor size, RENAL Nephrometry score (RNS), operative time, warm ischaemia time (WIT), estimated blood loss (EBL), and length of hospital stay. Results Between the two groups, the BMI, tumor size, WIT, length of hospital stay were similar [(26.70 ± 3.33) kg/m2 vs (25.65 ± 4.01) kg/m2, (3.53 ± 1.21) cm vs (3.64 ± 1.05) cm, (27.17 ± 7.55) min vs (25.21 ± 5.64) min, (12.54 ± 4.06) d vs (10.61 ± 3.70) d, P > 0.05)], as well as the ASA and RNS. APF patients were older [(59.25 ± 11.03) y vs (49.71 ± 11.86) y, P = 0.004]. There were a high proportion of men (75.0% vs 46.4%, P = 0.036), patients with hypertension (62.5% vs 28.6%, P = 0.014), and patients with diabetes (41.7% vs 14.3%, P = 0.026). In the APF group, IAF was more [(2.02 ± 0.47) cm vs (1.35 ± 0.66) cm, P = 0.000], operative time was longer [(146.08 ± 45.45) min vs (119.32 ± 28.83) min, P = 0.017], and EBL was higher [(82.92 ± 45.73) ml vs (51.79 ± 25.10) ml, P = 0.005]. Conclusion The adherent preirenal fat sticking renal results in a longer operative time and a higher EBL, but has no influences on the WIT and length of hospital stay. APF makes it difficult to expose the tumor, not to remove it.

Objective To investigate the method of the resectoscope combined with ureteroscope in seeking for the difficult ureteral orifice in glandular cystitis, which improved the success rate of double J stent insertion under endoscopy.Methods The clinical data of 8 patients with dififcult ureteral oriifce in glandular cystitis from March 2015 to May 2016 were retrospectively analyzed. All male patients, their age ranged from 38 to 64 years old, the average age was 44.3 years. The depth of the submucosa and muscle layer of the bladder lesion was treated by transurethral resection. The necrotic tissue of ureteral oriifce was excised, which revealed the changing of muscular layer of texture. Then, resected the muscle tissue, urine was seen through the thin layer of muscle tissue. Under the guidance of the guide wire was inserted, the ureteroscope observation was confirmed ureteral lumen and the double J stent was placed.Results All patients were successfully placed double J stent. The mean operation time was 83.2 min (range, 35.0~205.0 min). Intraoperative blood loss was range 20~50 ml. The catheter was removed in 3~5 d. The abdominal plain iflm was reviewed in 1 - 2 days and the position of the double J stent was good, there was no ectopic, distortion and so on. There was no complications occurred during the perioperative period.Conclusions Resectoscope combine with ureteroscope in seeking for the dififcult ureteral oriifce in glandular cystitis is an effective way of increasing the successful rate of ifnding dififcult ureteral oriifce. This method is safe,minimally invasive and avoiding open surgery.

Objective: To investigate the level of preschool children’s weekend screen time in Zhejiang Province, and to explore family related factors. Methods: A total of 6 829 preschool children were selected from 25 kindergartens in Zhejiang Province from March to April 2019. Through a questionnaire survey among their caregivers, relevant data and information such as children’s screen time and family related factors were obtained. Result: The report rate of children in different age groups whose average screen time per day on weekends ≥2 h/d: boys were higher than girls( P <0.05); and the difference between boys and girls in the age groups of 3, 3.5, 4 and 6 was statistically significant( P <0.05). At the age of 3, the lowest rate of video time ≥2 h/d report was 9.57% and 6.03% for boys and girls, while at the age of 5.5, the highest rate was 18.49% and 17.37% for boys and girls. Logistic regression analysis showed that age, boy( OR =1.33), caregiver( OR =1.42), father’s high school( OR =1.36), father’s junior high school and below( OR =1.37), and parents’ no exercise habit ( OR =1.47) were associated with high screen time during weekend( P <0.05). Conclusion Family related factors can affect children’s screen time. Parents should pay attention to children’s screen time in the process of children’s growth.

Objective: To explore sleep duration and associated factors among children aged 3-6 years old in Zhejiang Province. Methods: A total of 7 034 children aged 3-6 years from 24 kindergartens in Zhejiang province were selected through clustered sampling method. Through parental questionnaire, child sleep duration and associated factors were colleted. Possible influencing factors of sleep insufficiency were analyzed by logistic regression model. Results: The rate of insufficient sleep was 56.1%, with 57.1% for boys and 55.1% for girls in Zhejiang Province. The rate of insufficient sleep increased with the increase of age, which was 46.7%, 49.8%, 50.2%, 55.2%, 64.0%, 65.8% and 68.1% for 3.0, 3.5, 4.0, 4.5, 5.0, 5.5 and 6.0 years old group (χ 2=45.71, P<0.01), respectively. The rate of insufficient sleep was 59.9%, 54.7% and 45.6% for children with <1 h/d, 1-2 h/d and ≥2 h/d outdoor physical activity (χ 2=67.10, P<0.01). Multivariate Logistic regression model showed that children older than 4.5 years old, whose caregiver was other than parents, outdoor activity time< 1 h/d and 1-2 h/d, maternal education below junior middle school and senior high school were positiviely associated with sleep insufficiency [OR(95%CI) was 1.29(1.07-1.54), 1.97(1.64-2.37), 2.04(1.69-2.46), 2.35(1.82-3.03), 1.21(1.08-1.35), 1.73(1.49-2.01), 1.47(1.26-1.72), 1.35(1.15-1.59), 1.16(1.01-1.32), P<0.05]. Conclusion Sleep insufficiency among preschool children is associated with multiple factors, increase of age, insufficient outdoor activity and overdose screen time in particular. The finding calls for outdoor physical activity promotion among preschool children, especially for those whose caregivers are those other than parents.