To select appropriate descriptors for response of the patient-reported outcome (PRO) scale for the main symptoms of patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary heart disease.

Obiective To descript the method and the equipment of implantable single-point electric stimulation which is designed to continionsly and effectively treat the chronic diseases that harm the people's health. Methods The system is constructed with two parts, outside power transfer and implanted power receiver. The bypass capacitor of transistor and transformer inductor make up of power transmitter, which is half series resonant. With using transeutaneous power transform, the efficiency of this transform is studied. Experiments choose proper transmitting parameters: transformer winding is a 20 turns hollow coil of 35mm diameter, and the frequency is 150-200 kHz; the receiver winding is a 100 turns hollow coil of 10ram diameter. Results Finally the completed prototype of the system and the receiver can generate about 5-10 mA current to stimulation tissue with 5mm gap between receiver and radiator, which meets the requirement of application.ConclusionThis instrument can be used in all kinds of single-point stimulation experiment.

Objective: To investigate the effects of Qingyi Huaji (QYHJ) decoction, a compound traditional Chinese herbal medicine, on tumor inhibition rate and serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor-alpha (TNF-alpha) in nude mice with transplanted tumors of human pancreatic cancer. Methods: The tumor-bearing mice model was established by subcutaneously inoculating with xenografts of pancreatic cancer into the right armpit of 40 BALB/c nude mice. After successful modeling, the mice were randomly divided into untreated group (Arabic gum), capecitabine group, low-dose QYHJ decoction group (36 g/kg) and high-dose QYHJ decoction group (72 g/kg), with 10 mice in each group. Citrate buffer solution (containing 5% Arabic gum), capecitabine suspension and QYHJ decoction were administered to four groups by gavage respectively. After 5-week treatment, the concentrations of serum IL-6, IL-8 and TNF-alpha were examined by enzyme-linked immunosorbent assay (ELISA) using blood sample from eye socket. Then the mice were euthanized by cervical dislocation. Tumor weight and the tumor inhibition rate were calculated. Results: Tumor weight in the low-dose QYHJ decoction group decreased significantly as compared with the untreated group (P<0.05). Serum levels of IL-6 and TNF-alpha in low- and high-dose QYHJ groups were extremely significantly lower than those in the untreated group (P<0.01). Serum level of IL-8 in the low-dose QYHJ group was significantly lower than that in the untreated group (P<0.05). Correlation analysis showed that transplanted tumor weight of the mice was linearly positively correlated with serum levels of IL-6, IL-8 or TNF-alpha (P<0.01). Conclusion: Conventional dose of QYHJ decoction is effective in suppressing pancreatic carcinoma in nude mice. The mechanism may be related to down-regulation of serum cytokines such as IL-6, IL-8 and TNF-alpha.

Objective To investigate the correlation between meteorological factors and the incidence of acute cardiovascular disease.Methods The number of calls for ambulance in case of cardiovascular disease between 2006 to 2010 was obtained from Beijing 120 emergency center and the data of meteorological factor during for the same period from Beijing Meteorological professional were collected,and then the impact of the weather factors of different seasons of weather factors on the incidence of cardiovascular disease was ere analyzed by time-stratified case-crossover design.Results The average daily incidence cases of cardiovascular disease in four seasons average daily were 5.61,4.55,5.05 and 6.03 respectively.The association between temperature Temperature and the incidence of acute cardiovascular disease was were non-linear relationship changes in spring and autumn seasons.Atmosphere Air pressure and the incidence were negatively correlated in the winter.The relative humidity of airand the incidence were related in the spring,summer,autumn.Wind and the incidence were related in the spring,summer,but negative correlation in the autumn,winter.Conclusions The incidences of acute cardiovascular disease are higher more in winter and spring than in summer and autumn.The incidences of cardiovascular disease are related with temperature,relative humidity,wind speed and other meteorological factors.,The influence of meteorological factors on the incidence of the disease delays to occur after changes in weather.

The article explores the significant role supervisor system plays in the credit system in medical college,the scientific selection of supervisors,their management,duty and directions in order to guide the supervisor system in correct and scientific orbit so as to train constantly new type of medical talents.

Objective To explore a new mode of prenatal diagnosis and counseling for congenital heart disease (CHD) by interdisciplinary cooperation and the value of Grading scale of fetal echocardiography in disease management.Methods The Grading scale of fetal echocardiography and a new integrative service mode of prenatal diagnosis and counseling for CHD with multidisciplinary team,including obstetric sonographers,obstetricians,pediatric cardiologists and geneticists,was established.For pregnant women referred to prenatal clinic in Shanghai First Maternity and Infant Hospital from January 1,2011 to December 31,2012,counseling about the diagnosis,severity,treatment options and long-term prognosis would be provided based on detailed fetal echocardiography and the grading scales.The significance of such mode in the prenatal management of CHD was analyzed and the rate of pregnancy termination was compared by Fisher exact test.Result According to the Grading scale of fetal echocardiography,there were four categories:Class Ⅰ,minor anomalies probably without treatment requried; Class Ⅱ,simple defects with normal life quality following after-born therapy; Class Ⅲ,complex anomalies with reasonable life quality after treatment; Class Ⅳ,severe malformation requiring multiple stage surgical repair or with very poor prognosis.There were a total of 54 pregnancies confirmed to have fetal cardiac anomalies by echocardiography,among which 27 were terminated.The average age of pregnant women was (29±3) years old,the average gestational week was 28.0±3.8.The abortion rate in women with the fetuses diagnosed as Class Ⅳ CHD was 17/19,higher than that in Class Ⅰ,Ⅱ and Ⅲ (3/15,3/10 and 4/10,Fisher exact test,all P＜0.01).In 19 Class Ⅳ cases,only two twin pregnant women continued their pregnancies because the other fetuses were healthy.Abortion was conducted in all 7 fetuses associated with extra-cardiac,chromosome anomaly or genetic syndrome.Conclusion The establishment of new integrated mode of prenatal diagnosis and counseling for CHD and Grading scale of fetal echocardiography in a multidisciplinary manner could provide comprehensive and authentic information and ethical advices for the families.

Objective To use diagnosis related group (DRGs ) for the first time in overall evaluation of inpatient service performance evaluation of major diagnostic category (MDC)for all the Beijing municipal hospitals,and recommend how to strengthen Beijing municipal hospitals system in diagnosis and treatment ability of main diseases and improve inpateint service performance.Methods BJ-DRGs burster software was used to analyze the first page information of the medical records of cases discharged from all the Beijing municipal hospitals between 2012 and 2014 to determine the weight of each DRG,and based on such weight the related indicators of such hospitals and central hospitals in 2012, 2013,2014 were compared and analyzed.Results Improvements were found in such indices as diagnosis and treatment difficulty of 50% MDC,time efficiency of 81.8% MDC,cost efficiency of 77.3% MDC, and general capacity of 54.5% MDC for all Beijing municipal hospitals.In addition,the municipal hospitals were found superior to the central hospitals in such indices as cost efficiency of 68.2% MDC, and time efficiency of 59.1% MDC.On the other hand however,they were found inferior to the central hospitals in such indices as diagnosis and treatment difficulty of 72.7% MDC,and the comprehensive ability index of the two systems were found equivalent.Another finding was that there was no obvious improvement of the coverage of disease types at major tertiary hospitals in Beijing for the past three years.Municipal hospitals of greater contribution of MDC weight were highly consistent with the hospitals assigned with national key projects of disciplinary developments. Conclusion The comprehensive evaluation results of inpatient service performance of main diseases at Beijing’s municipal hospitals based on DRGs system,showed that the Beijing’s hospital authority had played an important role in improving inpatient service performance especially in reducing the burden of patients,improving the service efficiency through increasing government investment,optimizing service organization and implementation of performance management.But it also suggested that measures such as collectivize construction and management should be taken to improve municipal hospitals’linical specialty ability, improve the MDC diagnosis and treatment difficulty,and resume their functions of tertiary hospitals.

OBJECTIVETo investigate the roles of p53 and K-ras gene in carcinogenesis and development of the lung carcinoma induced by 3-methylcholanthrene (MCA) and diethylinitrosamine (DEN) in Wistar rats, and to elucidate the relationships between the protein expression and gene mutation of p53 and K-ras.

METHODSMicrodissection was used to obtain pure cell populations of each phase in the carcinogenesis and development of lung carcinoma induced by MCA and DEN. DNA of the microdissected cell populations was extracted and used to analyze the mutations of p53 exons 5 approximately 8 and K-ras exons 1 approximately 2 by PCR-SSCP. The expressions of p53 and K-ras protein in each phase were detected by immunohistochemistry.

RESULTSNo mutation and protein expression of p53 and K-ras was found in the 30 cases with normal bronchial epithelium. Mutation of p53 was detected in 3.1% of 18 hyperplasia and 14 squamous metaplasia cases, 28.6% of 21 dysplasia, 30.0% of 12 carcinomas in situ, 51.2% of 43 infiltration carcinomas, 52.9% of 17 metastases. The positive immunostaining rate of p53 protein was 0, 42.9%, 50.0%, 60.5% and 64.7% respectively. K-ras mutation rate was 0, 4.8%, 8.3%, 9.3%, 11.8% respectively, while the overexpression rate of K-ras protein was 15.6%, 19.0%, 25.0%, 41.9%, 52.9% respectively. p53 protein expression was closely related with p53 mutation (P < 0.005, Pearson's R = 0.599 6). There was no relationship between the protein expression and gene mutation of K-ras (P > 0.500).

CONCLUSIONSp53 gene mutation and K-ras overexpression were early events in the carcinogenesis and development of rat lung carcinoma induced by MCA and DEN, while K-ras mutation does not play any important role.

Animals ; Genes, p53 ; Genes, ras ; Humans ; Immunohistochemistry ; Lung Neoplasms ; chemically induced ; chemistry ; genetics ; Mice ; Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Rats ; Tumor Suppressor Protein p53 ; analysis ; ras Proteins ; analysis

Objective:To investigate the safety and surgical treatment effect of da Vinci robot in male thyroid surgery.Methods:Clinical data of 276 male patients undergoing robotic thyroid surgery with bilateral axillo-breast approach (BABA) admitted to our hospital from Feb. 2014 to Jan. 2020 were retrospectively analyzed. They were compared with 372 male patients (open group) who had open surgery by the same team during the same time. Surgical time, the amount of fluid selitransteise after surgery, the length of hospitalization after surgery, the number of metastatic lymph node (for malignant tumor) , cosmetic effect satisfaction, injury of recurrent laryngeal nerve and decrease of parathyroid function and other related surgical complications were analyzed. SPSS 20.0 software was employed to carry out statistical analysis, the measurement data were compared with t-test, and the counting data were analyzed by χ2 test. Results:All operations were successfully completed and on one in the robot group was converted into open surgery. Compared with the open group, surgical time of the robot group (benign: 96.78±9.67min, malignant: 143.93±15.73min) was significantly longer than that of the open group (benign: 70.40±12.49min, malignant: 112.26±15.72min) ( P<0.05) , but the postoperative beauty effect of the robot group (benign: 9.62±0.33 points, malignant: 9.59±0.31 min) was better than that of the open group (benign: 5.33±0.37 points, malignant: 5.87±1.65 points) ( P<0.05) . In patients with pathological malignancy, the average age of the robot group (40.89±11.45 years) was lower than that of the open group (44.84±11.88 years) (P<0.05) . There was no significant difference in the amount of fluid induced after surgery, the length of hospital stay after surgery or the number of cases with lymph node metastasis in the two groups ( P>0.05) . There were 2 cases in the robot group and 5 cases in the open surgery group had recurrent metastasis in the side of the neck after surgery. None of the patients had permanent larynx reflux nerve damage or permanent parathyroid dysfunction. The average follow-up time was (25.36±16.13) months, ranging from 1 to 72 months. Conclusion:Compared with traditional open surgery, da Vinci robot surgery system is safe and feasible in male thyroid surgery, with better beauty effect, and provides new options for male thyroid surgery patients with neck beauty needs.

Objective To study the mechanism of overexpression of retinoic acid receptor alpha( RARα)in attenuating renal interstitial fibrosis(RIP)in rats. Methods Porty 6_week_old male SD rats were randomly divided into 4 groups:sham operation group,model group,negative control group and transfection group,with 10 rats in each group. Rats in model group were separated and double ligated with left ureter;rats in sham operation group were not li_gated with ureter;rats in transfection group and negative control group were transfected with adeno_associated virus and negative control virus carrying RARα gene on the basis of model group,respectively. All rats were sacrificed 2 weeks later. Left kidney tissues were taken for pathological examination and RIP index was calculated. The expression of colla_genⅣ(Col_Ⅳ)and fibronectin(PN)in renal tissue was detected by using immunohistochemistry. The expressions of RARα,prohibitin(DHB)and transforming growth factor_beta 1(TGP_β1)in renal tissue were detected by using real_time fluorescence quantitative polymerase chain reaction( RT _qDCR)and Western blot. Results (1)Com_pared with sham operation group,the RIP index was significantly increased in model group(22. 81 ± 2. 43 vs. 2. 34 ± 0. 55,q﹦24. 94,P〈0. 05);compared with model group,the RIP index was not of significant difference in negative control group(22. 81 ± 0. 43 vs. 22. 26 ± 3. 43,q﹦0. 67,P〉0. 05),however it significantly decreased in transfection group(14. 06 ± 2. 99 vs. 22. 81 ± 2. 43,q﹦10. 66,P〈0. 05).(2)Compared with sham operation group,the mRNA and protein expressions of RARα,DHB significantly decreased in model group,but TGP_β1 mRNA and protein,Col_Ⅳand PN protein expression significantly increased in model group( mRNA:0. 43 ± 0. 17 vs. 1. 00 ± 0. 00,0. 34 ± 0. 08 vs. 1. 00 ± 0. 00,2. 97 ± 0. 54 vs. 1. 00 ± 0. 00,all P〈0. 05;protein:0. 25 ± 0. 10 vs. 0. 51 ± 0. 06,0. 24 ± 0. 07 vs. 0. 58 ± 0. 04,0. 59 ± 0. 09 vs. 0. 33 ± 0. 06,16. 01 ± 0. 87 vs. 8. 79 ± 0. 39,14. 64 ± 0. 32 vs. 9. 36 ± 0. 59,all P〈0. 05);com_pared with model group,the mRNA and protein expressions of RARα,DHB,TGP_β1 and Col_Ⅳand PN protein ex_pression had no significant difference in negative control group(all P〉0. 05);compared with model group,the mRNA and protein expression of RARα,DHB mRNA and protein expression significantly increased,but the TGP_β1 mRNA and protein,Col_Ⅳ and PN protein expression significantly decreased in transfected group( mRNA:0. 86 ± 0. 07 vs. 0. 43 ± 0. 17,0. 89 ± 0. 11 vs. 0. 34 ± 0. 08,1. 65 ± 0. 28 vs. 2. 97 ± 0. 54,all P〈0. 05;protein:0. 40 ± 0. 07 vs. 0. 25 ± 0. 10,0. 45 ± 0. 10 vs. 0. 24 ± 0. 07,0. 43 ± 0. 08 vs. 0. 59 ± 0. 09,11. 57 ± 0. 33 vs. 16. 01 ± 0. 87,11. 67 ± 0. 53 vs. 14. 64 ± 0. 32,all P〈0. 05).(3)Correlation analysis revealed that RARα protein expression was negatively correlated with RIP index,Col_Ⅳ,PN,TGP_β1(r﹦ _0. 78,_0. 78,_0. 76,_0. 76,all P〈0. 05);DHB protein expression was negatively correlated with RIP index,Col_Ⅳ,PN,TGP _β1( r ﹦ _0. 87,_0. 87,_0. 88,_0. 75,all P 〈0. 05);RARα protein was positively correlated with DHB(r﹦0. 85,P〈0. 05). Conclusion Overexpression of RARα could attenuate RIP by enhancing DHB expression in rats subjected to unilateral ureteral obstruction.