Objeetive To investigate the willingness to family care bed service and its influencing factors among the elderly with chronic diseases. Methods A three-stage random sampling method was adopted to carry out face-to-face questionnaire investigation in 652 community elderly patients with chron-ic diseases. Results The willingness to family care bed service was 57.2%.Its influencing factors includ-ed age,educational level,family economic income,activity of daily living,whether or not received treatment within 2 weeks and hospital stay within 1 year,whether or not understood the meaning of family care bed service or received it or similar at home service. Conclusions More than a half of the elderly with chronic diseases were willing to accept family care bed service.The community health service center or hos-pital should attaeh importance to and actively carry out family care bed service.They should enhance propanda work to induct the utilization of family care bed service by edlder people with chronic disease and tackle and satisfy their health requirement.

Objective To investigate the effect of the whole course health education on heart rehabilitation of old patients with percutaneous coronary intervention(PCI).Methods One hundred and twentyone old patients with coronary heart disease who all underwent complete PCI in Tangshan Gongren Hospital from January 2008 to December 2009 were selected as our subjects.All subjects were randomly divided into the intervention group (60 cases) and the control group (61 cases).All patients were treated by PCI ± standard drug therapy.Patients in control group were given the conventional health education,while in intervention group were given the extending health education plus the conventional health education.Questionnaire was used to collect the coronary heart disease knowledge,recovery and secondary prevention behavior.The levels of blood pressure,density lipoprotein cholesterol,fasting blood glucose (FB) were measured at 6,12,24 months at discharge hospital.Meanwhile the reaching standard rate of coronary heart disease risk factors control was also used to evaluate the effect of education.Results The scores of knowledge of coronary heart disease rehabilitation of intervention group at 6,12 and 24 months after discharge were (79.69 ± 4.66),(83.26± 8.38),(81.81 ± 9.21) respectively,higher than that of control group ((72.36 ± 8.16),(69.96 ± 10.69),(70.00 ± 11.32) respectively),and there were significant differences between groups(t =3.26,5.39 and 4.41respectively,P ＜ 0.05).The scores of the second level prevention act of intervention group were (79.00±5.65),(79.88 ± 6.34) and (79.13 ± 11.21) respectively,higher than that of control group((70.72± 7.59),(68.84 ± 5.36) and (66.52 ± 9.15) respectively),and there was significant difference between groups (t =3.75,5.99 and 3.63 respectively; P ＜ 0.05).The reach standard rate of low density lipoprotein cholesterol(LDL-C),exercise of intervention group at 6 months were 60.0％ (36/60),65.0％ (39/60),higher than that of the control group(37.7％ (23/61),32.8％ (20.61)),and there was significant difference between groups(x2 =6.045,10.871,P ＜0.05),while there was no significant difference in terms of the reach standard rate of blood pressure,FB and quit smoking(P ＞ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were 75.0％ (45/60),76.6％ (46/60),96.6％(58/60),81.7 ％ (49/60),75.0％ (45/60),higher than that of control group (49.2 ％ (30/61),32.8 ％(20/61),80.3％ (49/61),57.4％ (35/61),31.1％ (19/61),and there was significant difference between groups(x2 =8.021,28.438,8.431,10.435 and 23.128 respectively,P ＜ 0.05).The reach standard rate of blood pressure,LDL-C,FB,quit smoking,exercise of intervention group at 12 months were (75.0％ (45/60),81.7％ (49/60),95.0％ (57/60),86.7％ (52/60),81.7％ (49/60)),higher than that of control group (44.3％ (27/61),31.1％ (19/61),75.4％ (46/61),47.5％ (29/61),34.4％ (21/61)),and there was significant difference between groups (x2 =11.710,35.810,8.112,25.450 and 25.650 respectively,P＜0.05).Conclusion Whole course health education is proved to reach the purpose of long-term heart rehabilitation,and decrease the risk of the risk factors for PCI.Meanwhile it is a safe,effective,compliant heart rehabilitation model after PCI in old patients.

BACKGROUND:Matrix metaloproteinase-1 can degrade extracelular matrix, which is mainly colagen type I, and has the potential to reverse fibrosis tissue. OBJECTIVE:To construct the recombinant adenovirus vector containing human matrix metaloproteinase-1 (hMMP-1) gene with GatewayTM Clone Technology, and observe the capacity of degrading colagen type IIIin vitro. METHODS: The gene hMMP-1 was amplified by using PCR from the pcDNA3.1 plasmid and was cut down by the double endonuclease. The linear gene fragment was connected to the entry vector pENTERTM 1A. Then the entry clone and the destination vectors pJTI? R4 Dest CMV-N-EmGFP pA Vector recombined using the LR reaction to form the expression clone pAd-hMMP-1-eGFP. The linear pAd-hMMP-1-eGFP cut down by endonucleasePac I was transfected into HEK293A cels to packaging the Ad-hMMP-1-eGFP. The transfected situation was observed under a fluorescence microscope, the target protein expression was detected by western-blot assay and RT-PCR. Cels can be divided into three groups: blank control group: HEK293A cels, AD-EGFP group: HEK293A cels were infected by Ad-eGFP, AD-HMMP1-EGF group: HEK293A cels were infected by Ad-hMMP1-eGFP and colagen type III. The content of colagen type III was detected by ELISA kits after 24, 48 and 72 hours. RESULTS AND CONCLUSION: It was confirmed that the entry vector and the destination vector both contained hMMP-1 target gene by restriction analysis and sequencing. The green fluorescent protein was observed in the 293A cels transfected by the Ad-hMMP-1-eGFP at 4 days. The fluorescence intensity was the highest at 10 days. The virus was colected at 12 days, the viral titer was determined as 4.84 × 1010 PFU/mL, the target protein was efficient expressionvia western-blot assay. Blank control group and AD-EGFP group had no obvious change of colagen content with the extension of time. The rate of colagen degradation in AD-HMMP1-EGFP group was 24%, 56% and 81% respectively at 24, 48, 72 hours. AD-HMMP1-EGFP group degraded colagen significantly compared with the other two groups (P < 0.01). The recombinant adenovirus vector containing hMMP-1 was successfuly constructed by using the Gateway technology, this method was more efficient and specific than with the traditional methods. The hMMP1 degraded colagen type III significantlyin vitro.

The theory of body and spirit is one of the basic theories of TCM; it plays an important role in the development of TCM theory system,and has guiding significance in the clinical practice.The connotation of theory of body and sprit is copious and text mining can find potential valuable information from plenty of message.We tried to use text mining to find the connotation of theory of body and sprit,and provided a new way to study the theory of TCM.

Treatment based on syndrome differentiation which is a complicated procession,is a characteristic of Chinese medical diagnosis and treatment.How to appraise the efficacy of treatment based on syndrome differentiation becomes a important question.Randomized controlled trial is called golden design of clinical trial,but it has a strict condition and a low compliance.Cohort study has a high clinical operation,but it is difficult to control bias.Stratified,polycentric and prospective cohort study can avoid the shortcomings of randomized controlled trial and cohort study.So,it can be a prospective design to appraise the curative efficacy of treatment based on syndrome differentiation.

Objective:To analyze the clinical and gene mutation characteristics of congenital disorder of glycosylation (CDG) caused by compound heterozygous mutation of the COG6 gene ( COG6-CDG). Methods:This study retrospectively analyzed the clinical data and genetic test results of a patient with COG6-CDG in Bayi Children's Hospital, the Seventh Affiliated Medical Center of Chinese PLA General Hospital, in August 2019. Literature was retrieved with keywords including COG6, COG6-CDG, congenital disorders of glycosylation typeⅡL and congenital disorders of glycosylationⅡL in China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, and Web of Science Database from the establishment to July 2020, to summarize the clinical and genetic characteristics of COG6-CDG. Results:(1) Case report: The 59-day-old baby boy, with a gestational age of 27 +5 weeks and birth weight of 1 180 g, presented with multi-system involvement on admission, including unidentified progressive hepatosplenomegaly with jaundice and ascites, persistent thrombocytopenia, microcephaly, hypotonia, hypohidrosis, hyperkeratosis, and recurrent hyperthermia, infection, and hypoglycemia, as well as dysfunctions of the heart, gastrointestinal tract, lungs, kidneys, ocular fundus, and the coagulation system. Despite given ventilator-assisted ventilation, anti-infection therapy, abdominal puncture and drainage, and blood transfusion, the patient still had an aggravated condition and eventually died of multiple organ failures 192 d after birth. Genetic analysis showed that the nuclear family carried compound heterozygous mutations in the COG6 gene (NM_020751.2), including missense mutations of c.662C>T(p.T221M) in exon 7 and c.443T>C(p.I148T) in exon 5, which were both novel mutations and originated from the mother and father, respectively. (2) Literature review: Eight related papers were retrieved, including 20 cases. The main manifestations were various degrees of nervous system abnormalities and growth retardation, complicated by abnormalities of the liver, heart, gastrointestinal tract, blood, immunity, teeth, and bones. All the reported cases suffered from mental and growth retardation, and nine deaths were reported. A total of 11 COG6 gene mutations were identified, and most of them were c.1167-24A>G splicing mutations in a deep intron (seven cases), followed by c.1646G>T (four cases) and c.511C>T (three cases). Conclusions:COG6-CDG commonly manifests as multi-system and multi-organ dysfunctions with poor prognosis. Gene detection is conducive to the accurate diagnosis of COG6-CDG. Our case carries compound heterozygous mutations of c.662C>T(p.T221M) and c.443T>C(p.I148T), which are unreported novel mutations.

Objective To evaluate the efficacy of Six Sigma management for shortening the waiting time of outpatients accepting radiography and improving patient satisfaction. Methods Six Sigma management was applied to identify the key points critical to quality in the process of radiography,analyze the factors influencing the waiting time,and take targeted measures to modify the process. Results The waiting time of patients accepting radiography was reduced by an average of 25.2min and the rate of dissatisfaction was decreased by 18%. Conclusion The application of Six Sigma management can effectively shorten the waiting time of outpatients accepting radiography and increase patient satisfaction.

Purpose To compare the mammography and ultrasound imaging features of triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (NTNBC), and to improve TNBC diagnosis. Materials and Methods Using immunohistochemical staining technique, 387 patients with pathologically conifrmed breast cancer were divided into TNBC group (n=54) and NTNBC group (n=333). Mammography and ultrasound ifndings as well as pathological data were retrospectively reviewed. Results TNBC was associated with higher tumor grades. There were signiifcantly more grade III inifltrating ductal carcinomas and axillary lymph node involvement in TNBC group than in NTNBC group (χ2=47.009, P<0.001;χ2=4.658, P<0.05). On mammography, TNBC most frequently presented with a mass (n=37, 69.8%) and was less associated with microcalciifcations (n=10, 18.9%). TNBC masses were mostly round or oval (n=28, 62.2%) with circumscribed margin (n=16, 35.6%). Spiculated margins were rare (n=5, 11.1%). NTNBC most frequently presented as a mass with calciifcations (n=138, 42.1%), and was more irregular in shape (n=119, 46.5%). Spiculated margins were common (n=77, 30.1%). There was statistically signiifcant difference between these two groups in mass, microcalcification, shape and margin (χ2=24.618, 19.889, 32.605 and 21.102, P<0.001). On ultrasonograhy, TNBC most frequently presented as a mass (n=52, 96.3%) with less microcalciifcations (n=5, 9.3%). TNBC masses were more frequently round or oval (n=27, 51.9%) with circumscribed margins (n=25, 48.1%). Spiculated margins were rare (n=3, 5.8%). TNBC was less likely to show attenuating posterior echoes (n=5, 9.6%);NTNBC most frequently presented as a mass (n=318, 96.1%) with microcalcifications (n=135, 40.8%). NTNBC masses were more frequently irregular in shape (n=243, 76.4%) with spiculated margins (n=76, 23.9%). NTNBC was more likely to show attenuating posterior echoes (n=78, 24.5%). There was statistically signiifcant difference between these two groups in microcalciifcation, shape, margin and posterior echo (χ2=19.006 and 18.339, P<0.001;χ2=16.170 and 8.429, P<0.05). Conclusion TNBC demonstrates round or oval mass with circumscribed margin and is less likely to show attenuating posterior echoes on mammography and ultrasound with benign imaging features. NTNBC frequently presents as irregular mass with spiculated margin, and is more associated with microcalciifcations. These imaging ifndings are useful in early diagnosis of TNBC.

Objective To preliminarily explore the expresssion of the Hedgehog signaling pathway (HH) after different liver trauma, and provide basis for the blockaded effection of HH and the potentiality of new traditional Chinese medicine exploition. Methods After adaptive breeding for one week, a cohort of 140 male SPF Fisher 344 rats were randomly divided into Retrorsine injection (R) indicated the toxical of chemical damage of liver, partial hepatectomy (PH) indicated the acute liver trauma, retrorsine/partial hepatectomy (R/PH) for the hepatic stem cells regeneration, and normal control (N) groups. The administering of retrorsine or placebo, and PH or sham operation were performed as Gordon’s matheds. RT-PCR, real-time PCR and immunohistochemistry were performed to detect the expression of the constituents related to HH after liver damage. Results RT-PCR demonstrated that the mRNA expression of IHH, PTCH, Smo, Gli1, Gli2, Gli3 were all activated in primary liver cells after different kinds of liver damage. The results of real-time PCR analysis indicated an interaction effect existing between the treatment and the time in 3 Hedgehog-related constituents (signaling molecule IHH, indicators of the HH activation Ptc, Gli1) (all P<0.001). The protein expression of PTCH in liver tissue section was confirmed by immunohistochemistry, which differed in the duration in PH and R/PH groups. Conclusion The HH was abnormally activated during the different liver trauma. It’s maybe an important signaling pathway during the liver’s reaction after damage.