This paper introduces a solution to the development of next-generation telemedicine system based on Ipv6 with the analyses of present situation and related problems of telemedicine system.The devices,advantage of new system and a successful program based on Ipv6 are also mentioned.

Objective To explore the effects of botulinum toxin type A (BTX-A) on the F-waves of the tibial nerve and the walking ability of stroke patients.Methods Twenty stroke patients with spastic hemiplegia of a lower limb were randomly divided into experimental and control groups with 10 patients in each group.All received four weeks of conventional rehabilitation,including walking training,balance training and muscle strength training.In the experimental group,a total of 300 IU of BTX-A was injected into the gastrocnemius (200 IU) and soleus muscles (100 IU)before the start of routine rehabilitation,guided by using the electrical stimulation.Muscle tone was assessed using the modified Ashworth scale(MAS).Walking ability was assessed with the timed up and go test (TUGT) and a 10 m free walking test.F-wave parameters were recorded in the tibial nerve before,two weeks and four weeks after the injection.Results In the experimental group there was a significant difference in F-wave amplitude between those recorded before treatment and after two weeks of treatment.The control group showed no statistically significant difference.In experimental group there was also a statistically significant difference in triceps muscle tension before and after treatment which was not observed in the control group.Walking ability improved significantly in both groups.Conclusions Local injection of BTX-A into the lower limbs can reduce the F-wave amplitudes of spinal cord motor neurons.BTX-A injection combined with rehabilitation training can significantly improve the walking ability of stroke patients.

Objective To investigate the effects of penehyclidine (PHCD) pretreatment on nuclear factor kappa B ( NF-kB ) activity during lipopolysaccharide ( LPS )-induced acute lung injury ( ALl ) in neonate rats.Methods Thirty 7-day old Wistar rats of both sexes weighing 18-21 g were randomly divided into 3 groups ( n =10 each): group Ⅰ control (group C); group Ⅱ LPS; group Ⅲ PHCD. Group Ⅱ and Ⅲ received intraperitoneal ( group IP) LPS 3 mg/kg. In group Ⅲ PHCD 5 mg/kg was administered IP at 30 min before LPS respectively. The animals were killed at 4 h after LPS administration. The lungs were immediately removed. The W/D lung weight ratio was measured. The TNF-α, IL-1 βand IL-10 content in the lung were detected by ELISA and expression of NF-kB p65 was detected by immuno-histochemical staining.Results LPS significantly increased W/D lung weight ratio, TNF-α, IL-1 β, IL-10 content and NF-kB p65 expression in the lung as compared with control group. PHCD administered before LPS significantly attenuated the LPS-induced changes. Electron microscopy showed that PHCD before LPS significandy ameliorated the LPS-induced histological damages. Conclusion Pretreatment with PHCD can attenuate LPS-induced acute lung injury though inhibition of NF-kB activation and inflammatory response of lung tissue in neonate rats.

Objective To detect the levels of the mRNA expression of TIM-3,TIM-1,T-bet,GATA-3,IFN-γ,IL-4 and Galectin-9 in the peripheral blood monocytes (PBMCs) of the patients with Graves disease(GD),and to explore their potential role in the pathogenesis of GD.Methods We used fluorescence quantitative real-time reverse transcription-polymerase chain reaction to measure the mRNA expression of TIM-3,TIM-1 and other associated genes in PBMCs of 70 patients with GD and 22 healthy controls.In addition,we analyzed the relationship of TIM-3,TIM-1 and other associated genes.Results The expression of TIM-3 and TIM-1 mRNA in the PBMCs from GD patients were abnormally higher,the GD patients with Graves' ophthalmopathy group had significantly higher level of TIM-3 mRNA expression than that of GD patients without Graves' ophthalmopathy group,but no statistically significant difference was found in the expression of TIM-1 mRNA.Untreated GD patients had significantly higher level of TIM-3 mRNA expression than that of GD patients in recurrence group,however the expression of TIM-1 mRAN was opposite.But no statistically significant difference was found in TIM-3 mRNA expression of recovery GD patient and healthy control group.Though the expression of TIM-1 mRNA was significantly decreased,it was still higher than that of the normal control group.Conclusion TIM-3 and TIM-1 may participate in the occurrence,development and turnover of GD.TIM-3 or TIM-1 may prove to be an important target for developing new drugs and treatments to GD.

Objective To evaluate the clinical performance of CLINITEK Atlas urine dry chemistry analyzer and its supplementary strips,which could be used for other hospitals as reference.Methods Five hundred and one samples of random fresh urine were collected and analyzed by CLINITEK Atlas urine dry chemistry analyzer.10 parameters were reported for each sample,including SG,pH,BLD,LEU,PRO,GLU,KET,UBG,BIL and NIT.According to the medicals standard of the People's Republic of China,General Technical Requirements for Urine Analyzer(YY/T 0475-2004),General Technical Requirements for Chemical Reagent Strips for Urinalysis(YY/T 0478-2004)and physical,Chemical and Microscopic Examination of Urine(WS/T 229-2002),the precision,accuracy,carryover,stability,sensitivity and consistency of each parameter were evaluated.The agreement was assessed between the results for BLD and LEU obtained from CLINITEK Atlas analyzer and phase contrast microscope,and calculated the sensitivity and specificity of CLINITEK Atlas analyzer for BLD and LEU using phase contrast microscope as the gold standard.SG and pH test was performed among 200 specimens by CLINITEK Atlas analyzer,and then compared with the results obtained from MASTER-SUR-NM specific gravity refractometer and pH precision test strips respectively.In addition to SG and pH,the other eight parameters were compared with the results obtained from CLINITEK 500 urine analyzer,and Kappa value and consistency were calculated.Results The accuracy,precision,sensitivity,carryover and stability of 10 parameters could meet all the requirement of standards.SG and pH had good correlation with urine specific gravity refractometer (r =0.9838,P ＜0.001)and pH meter (r =0.8884,P ＜0.001),respectively.Compared with phase contrast microscope,BLD and LEU had coincidence rates of 90.4％ and 90.8％,respectively; Sensitivities were 90.7％ (301/332) and 83.3％ (200/240) ; Specificities were 89.9％ (152/169) and 97.1％ (255/261).Compared with CLINITEK 500,all the parameters,except for SG and pH,had good coincidence rates of ＞ 87.6％.Conclusion The performance of CLINITEK Atlas urine dry chemistry analyzer can meet the clinical requirements of all standards.

Objective:In order to ascertain the lateral operation and medial maxillectomy affect on nasal airway.Method:Report 16 cases of nasal cavity or nasal sinus neoplasm who were therapied by lateral rhinotomy and medial maxillectomy.They were observed by acoustic rhinometer (AR) and CT examination in 1～2.5 years after the surgery. Result:The feeling of nasal obstruct were disappeared in 3 months after the surgery. The nasal airway resistance(NAR) of the ill nasal cavity was markedly decreased after the surgery, and the total NAR were decreasing unmarkably. The mucous proliferation was notable only in the first year after surgery, and especially on remains of the inferior turbinate or extra wall of nasal cavity.Conclusion:Lateral rhinotomy operation and medial maxillectomy have less impact on nasal airway and the functions.

Objective To compare the curative effect between minimal invasive internal fixation with Mast Quadrant and tra -ditional open internal fixation for treating thoracolumbar fractures .Methods A total of 46 cases suffered thoracolumbar fractures were randomly divided into the minimally invasive group (MQ) and the traditional open group (TO) ,the patients in MQ group re-ceived minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive channel ;the patients in TO group received pedicle internal fixation under traditional open channel .Perioperative related indicators ,imaging indicators and improvements of low back pain were recorded and statistically compared respectively .Results The different of the volume of blood loss ,operation time and length of incision and postoperative volume of drainage between the two groups were statistically significant (P < 0 .05) ,the different of the volume of hospital duration ,postoperative VAS score between the two groups were statistically significant (P <0 .05) .The different of the volume of flange height in injured vertebral fanterior ,Cobb Angle between preoperative and postopera-tive were statistically significant (P< 0 .05) .And comparison between groups had no statistical significance (P> 0 .05) .Conclusion Compared with traditional open operation ,minimally invasive pedicle internal fixation under Mast Quadrant minimal invasive chan-nel has the advantage of more simple operation ,less intraoperative bleeding and postoperative pain less invasive ,fast recovery and short hospitalization stay .

Objective To study the reasonable doses, efficacy and safety of regional citrate anticoagulation (RCA) for continuous veno-venous hemofiltration(CVVH) in children. Methods There were 66 patients hospi-ta-lized in Pediatric Intensive Care Unit of Zhujiang Hospital,Southern Medical University treated with RCA-CVVH that were recruited in the study from October 2012 to July 2014. The patients were divided into 4 groups according to their weight:≤10 kg( group Ⅰ) ,20 kg≥weight>10 kg( group Ⅱ) ,30 kg≥weight>20 kg( group Ⅲ) ,>30 kg( groupⅣ),and each group randomly received 2 different doses of anticoagulant acid citrate dextrose formula A(ACD-A):ACD-A(mL/h)=0. 75×blood flow rate(BFR)(mL/min)(A dose) and ACD-A=1. 5×BFR(B dose). Data of hemo-filter duration, activated partial thromboplastin time( APTT) ( systemic and circuit) , ionized calcium( Ca2+) ( systemic and circuit), blood urea nitrogen(BUN), serum creatinine(Cr), alanine aminotransferase(ALT), aspartate amin-otransferase(AST), blood pH, sodium ion(Na+), bicarbonate ion(HCO3-) were collected and analyzed. Results There was no significant difference in BUN,Cr,ALT,AST and APTT of 2 different doses of ACD-A among the groups (all P>0.05);pH of B dose of ACD-A in group Ⅰwas significantly higher than that in A dose(F=7.384,P=0. 015);pH of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 492,P=0. 046),HCO3-of B dose of ACD-A in groupⅠwas significantly higher than that in A dose(F=7. 735,P=0. 013);HCO3-of B dose of ACD-A in groupⅡwas significantly higher than that in A dose(F=4. 644,P=0. 042);hemofilter duration of B dose of ACD-A in group Ⅲ was significantly higher than that in A dose(t=-3. 147,P=0. 016);hemofilter duration of B dose of ACD-A in groupⅣwas significantly higher than that in A dose(t=-6. 342,P=0. 000). Conclusions RCA-CVVH is effective and safe for critical children,and different doses of ACD-A for children with different weight can re-duce metabolic alkalosis and enhance regional anticoagulation.

Objective: To investigate the effect of nocturnal hypertension in essential hypertension (EH) patients with early renal dysfunction. Methods: A total of 182 EH patients were enrolled in this study. According to weather the average night blood pressure (BP) > 120/70 mmHg, the patients were divided into 2 groups: Nocturnal hypertension group,n=89 and Control group,n=93. The levels of urine micro albumin (mALB), podocalyxin (PCX) and serum Cyst-C were examined and compared between 2 groups. Results:① For BP: the average systolic and diastolic BP in Nocturnal hypertension group were higher than those in Control group as SBP (138.05 ± 6.33) mmHg vs (102.51 ± 8.76) mmHg, DBP (84.11 ± 6.32) mmHg vs (70.03 ± 4.56) mmHg, P<0.05. ② For renal dysfunction biomarkers: several biomarker levels were higher in Nocturnal hypertension group than those in Control group as mALB (13.60 ± 0.69) mg vs (10.04 ± 0.73) mg, PCX (5.35 ± 1.69) ng/ml vs (2.05 ± 0.88) ng/ml and serum Cyst-C (1.35 ± 0.69) mg/L vs (1.02 ± 0.44) mg/L, allP<0.05.③ For correlation study: In Nocturnal hypertension group, the PCX level was positively correlated to the levels of mALB (r=0.675,P<0.05), Cyst-C (r=0.734,P<0.05), night BP (r=0.830, P<0.05) and the duration EH (r=0.688,P<0.05). Conclusion: EH patients with nocturnal hypertension have more incidences to suffer from renal dysfunction, the examination of mALB, PCX and Cyst-C are beneifciary for the early diagnosis in relevant patients.

Objective To evaluate the effect of dexmedetomidine on myocardial injury in infants undergoing repair of ventricular septal defect.Methods Forty ASA grade Ⅱ or Ⅲ infants,aged 3-6 months,weighing 4-6 kg,scheduled for elective repair of ventricular septal defect,were randomly divided into 2 groups (n =20each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,etomidate,cisatracurium and sufenanil.The infants were mechanically ventilated after nasotracheal intubation.PET CO2 was maintained at 30-40 mm Hg,Anesthesia was maintained with cisatracurium,sufenanil and sevoflurane.In group D,dexmedetomidine was infused at 0.5 μg· kg-1 · h-1 until the end of operation.While in group C normal saline was given at the same rate until the end of operation.BP and HR were recorded at 10 min before operation (T1),skin incision (T2),chest opening (T3),10 min after aortic unclamping (T4) and the end of operation (T5).Blood samples were taken from the right internal jugular vein for determination of plasma creatine kinase MB (CK-MB) activity and cardiac troponin T (cTnT) concentrations at T1,T5 and 24 h after operation (T6).Results Compared with the baseline value at T1,no significant changes were found in HR and BP at different time points in group D,HR and BP were significanfly increased at T2-T5 in group C,and the plasma CK-MB ctivity and cTnT concentration were significantly increased at T5 and T6 in the two groups (P ＜ 0.05).HR and BP at T2-5 and plasma CK-MB activity and cTnT concentration at T5 and T6 were significantly lower in group D than in group C (P ＜0.05).Conclusion Dexmedetomidine infused at 0.5 μg· kg-1 · h-1 after induction can reduce myocardial injury in infants undergoing repair of ventricular septal defect.